Infectious Diseases in Critical Care Medicine

Disease External eye findings Fundoscopic findings

Bacterial endocarditis l Conjunctival hemorrhage
l Subconjunctival hemorrhage
SL:
l None

l Roth spots

l Cotton-wool spots

l Retinal hemorrhages

l Branch/central retinal artery

occlusion

Figure 4 Branch retinal artery

occlusion (see color insert).

Disease External eye findings Fundoscopic findings

Cytomegalovirus (CMV)
Ocular CMV seen in HIV-
infected patients with
CD4<50 cells/ mm^3

l Often has no remarkable external

ocular manifestations

SL:

l Fine keratic precipitates

l Anterior uveitis +/–

Figure 5 Keratic precipitates

(see color insert).

l Granular yellow–white

opacities with irregular borders

(lesions usually originate on

the periphery and spread

centrally)

l Retinal hemorrhage “Cheese

Pizza” appearance

l “Frosted branch angiitis”

(vascular sheathing)

Figure 6 CMV retinitis (see

color insert).

Figure 7 “Frosted branch

angiitis” (see color insert).

Ophthalmologic Clues to Infectious Diseases and Their Mimics in Critical Care 69