A IDS is a devastating disease that affects 28,000 people in the United States and has claimed over 16,000 lives. More than 270,000 persons are expected to contract the syndrome by 1991. Most AIDS patients are male homosexuals, intravenous drug users, of Haitian descent, or hemophiliacs. The causative agent in AIDS is the retrovirus HTLV-III/LAV. Infection with the AIDS virus causes a major collapse of the T-cell arm of the immune system, rendering the host vulnerable to a multitude of opportunistic infections and neoplasms. The most common fundus change observed in AIDS is cotton-wool spots. Cytomegalovirus (CMV) retinitis is the most damaging ocular finding since it may lead to total retinal atrophy. Retinal hemorrhages, Roth spots, and periphlebitis are manifestations of microvascular alterations that occur in AIDS. Opportunistic infections by Toxoplasma sp. and Mycobacterium sp. may also be manifest.
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