Immune recovery uveitis

Abstract

Potent antiretroviral therapy can result in substantial improvement in the immune function of patients with AIDS. In some patients with preexisting cytomegalovirus (CMV) retinitis, a consequence of this improved immune function is increased intraocular inflammation. This phenomenon, termed 'immune recovery uveitis', is characterized by anterior segment and vitreous inflammatory reactions. It can lead to the development of chronic, vision-limiting complications, including macular edema and epiretinal membrane formation. The frequency with which immune recovery uveitis occurs and risk factors for its development have not yet been clarified. There is evidence that these inflammatory reactions are directed toward CMV antigens in ocular tissues, although specific disease mechanisms remain poorly understood. Macular edema and decreased vision may respond, at least transiently, to corticosteroid therapy, but successful long-term treatment strategies have not been established. Immune recovery uveitis is currently one of the most common causes of new vision loss in patients with AIDS-related CMV retinitis.