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Human immunodeficiency virus retinopathy with presumed cytomegalovirus retinitis with macular oedema in a diabetic
  1. Chaitra Jayadev1,
  2. Srinivasan Sanjay2,
  3. Ashit Handa1 and
  4. Sameeksha Agrawal1
  1. 1Vitreoretina Department, Narayana Nethralaya, Bengaluru, Karnataka, India
  2. 2Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India
  1. Correspondence to Dr Chaitra Jayadev; drchaitra{at}


A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (NPDR) presented with decreased vision, worsening of retinal pathology and macular oedema in both eyes. His corrected distance visual acuity (CDVA) was 6/9 in the right eye and 6/15 in the left eye and fundus examination showed multiple intraretinal haemorrhages in all quadrants. His systemic workup revealed a severe thrombocytopaenia, which prompted a further detailed systemic evaluation revealing him to be positive for HIV with retinopathy complicating the pre-existing NPDR. Given the significant inflammation and macular oedema, a cocktail of intravitreal bevacizumab, ganciclovir and dexamethasone was administered. The retinopathy and macular oedema resolved and the CDVA improved to 6/6 in both eyes over a 6-month follow-up period. Any sudden worsening of fundus findings in a patient with diabetes necessitates immediate and detailed ocular and systemic evaluation, especially when the immune status is unknown.

  • Macula
  • Retina
  • HIV / AIDS

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  • Contributors CJ and SS are the treating physicians and finalised the manuscript. AH and SA collected the images, prepared the draft and conducted the literature search.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.