<prompt> An HIV patient complains for visual disturbances fundal examination shows bilateral retinal exudates and perivascular hemorrhages. Which of the following viruses are most likely to be responsible for this retinitis :Herpes simplex retinitisHuman herpes virusCytomegalovirusEBV  <response>: Ophthalmologic manifestations of HIV infection The MC abnormal finding on fundus examination are cotton wool spots. They represent area of retinal ischemia secondary to microvascular disease. These lesions are not associated with visual loss. CMV Retinitis : MC cause of vision loss in AIDS patient. Usually occurs when CD-4 50 μ l. Usually present as painless progressive of vision, patient may also complain of floaters and scintillations. The characteristic appearance is that of perivascular hemorrhage and exudate. It may be complicated by rheumatogenous retinal detachment. Treatment - oral valganciclovir, IV ganciclovir - DOC Acute retinal necrosis syndrome Progressive outer retinal necrosis PORN : Caused by herpes simplex virus, varicella zoster virus. Associated with pain, keratopathy iritis. Ophthalmologic examination show widespread pale grey lesions. DOC is intravenous acyclovir. Other secondary infections include : P.carnii - Cause lesion of choroid. Toxoplasmosis - Cause chorioretinitis. 