To investigate the clinical characteristics and visual outcome of cytomegalovirus retinitis in Korean patients with acquired immunodeficiency syndrome (AIDS) in the highly active antiretroviral therapy (HAART) era.

The medical records of 252 patients from Seoul National University Hospital who were diagnosed with AIDS between 2003 and 2006 were reviewed retrospectively. In addition, 15 patients (19 eyes) Having cytomegalovirus (CMV) retinitis with a minimum follow-up period of more than a year were included. Visual acuity, immune status, involved retinal area, and bilaterality were analyzed.

All patients were treated with the HAART regimen and an anticytomegaloviral agent with the exception of two patients. In all patients, immune recovery developed and retinitis was inactivated. Moderate (≤ 0.4) and severe (≤ 0.1) visual loss developed in 10 (52%) eyes and 9 (47%) eyes, respectively. Retinal detachment and involvement of posterior pole accounted for more than 80% (8 out of 10) of moderate, and 88% (8 out of 9) of severe visual loss. Patients with bilateral retinitis were more likely to develop retinal detachment and visual loss. Delayed immune recovery was associated with moderate visual loss.

Posterior pole involvement and retinal detachment were the major cause of visual loss in CMV retinitis in AIDS patients. Bilateral involvement and delayed immune recovery were related to retinal detachment and a poor visual outcome.