Spontaneous appearance and healing of frosted branch angiitis in CMV retinitis

A 44-year-old woman with known human immune-deficiency virus (HIV) infection on antiretroviral therapy (ART) was diagnosed with CMV retinitis in her left eye [Fig. 1]. Corrected visual acuity was 2/60 in left eye, and right eye was normal. Her CD4 count was 307. The patient was started on valganciclovir 900 mg BD. The patient presented with further deterioration at one month with acuity of counting fingers, worsening of CMV retinitis, and frosted branch angiitis [Fig. 1b]. Her CD4 count at this time was 464. The patient was continued on oral valganciclovir and 4 weeks later, visual acuity improved to 6/60, CMV retinitis had healed, and frosted branch retinitis had resolved completely [Fig. 1c]. The frosted branch angiitis may be a manifestation of immune recovery in these patients and may resolve spontaneously as seen in this case.[1]Figure 1: A 44-year-old woman with known HIV on ART was diagnosed with CMV retinitis in her left eye (a). The patient presented with further deterioration at one month with acuity of counting fingers, worsening of CMV retinitis, and frosted branch angiitis (b). The patient was continued on oral valganciclovir and 4 weeks later, visual acuity improved to 6/60, and CMV retinitis had healed and frosted branch retinitis had resolved completely (c)Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.