A 41-year-old man with AIDS presented with decreased vision in the left eye; he denied other symptoms. Medications included efavirenz, tenofovir, and emtricitabine, and his CD4 cell count was 31 cells/μL. He had been diagnosed 8 months previously with acute retinal necrosis in the right eye, with no light perception. Examination of the left eye showed minimal inflammation in the anterior chamber and vitreous. Ophthalmoscopy showed hemorrhagic papillitis, retinal necrosis, hemorrhage, and diffuse vascular sheathing.
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