The spectrum of eye disease in children with AIDS due to vertically transmitted HIV disease: Clinical findings, virology and recommendations for surveillance

Background: Eye dis ease in children infected with HIV is uncommon, but there is little information on which children require screening or surveillance and the management of those with retinitis. Methods: We examined 12 children with symptomatic HIV disease (of a cohort of 98 HIV-positive children) using indirect ophthalmoscopy. When retinitis was found it was documented photographically at the time of diagnosis and on follow-up. Results: Four cases of infective retinitis were diagnosed: three with probable cytomegalovirus retinitis and one with progressive outer retinal necrosis. Conclusion: Detection of reactivation is difficult and we recommend fundus photography under general anaesthesia wherever possible. Children with other end-organ disease, symptomatic eye disease and advanced HIV disease with severe immunosuppression require ophthalmological surveillance.