MULTIFOCAL RETINAL INFILTRATES WITH PHLEBITIS AND OPTIC NEUROPATHY IN AN HIV-POSITIVE PEDIATRIC PATIENT Sundeep K. Kasi, MD,* Robin A. Vora, MD,† Taliva Martin, MD,‡ Emmett T. Cunningham, Jr., MD, PhD, MPH‡§¶** Purpose: To describe an unusual presentation of bilateral HIV-associated multifocal retinal infiltrates with phlebitis and optic neuropathy in a pediatric patient from Zimbabwe, Africa. Methods: Retrospective case report of a 15-year-old boy from Zimbabwe, Africa. Results: The patient was found to have bilateral vitritis, multifocal retinitis with phlebitis, and optic neuropathy in the setting of previously unrecognized HIV infection. Vision improved and the clinical findings resolved after treatment with intravenous corticosteroids and highly active retroviral therapy (HAART). Conclusion: The authors describe the occurrence and treatment of bilateral, HIV- associated multifocal retinal infiltrates with phlebitis and HIV-associated optic neuropathy in a pediatric patient from Zimbabwe, Africa. RETINAL CASES & BRIEF REPORTS 9:311–314, 2015 From the *Department of Ophthalmology, University of California San Francisco, San Francisco, California; †Department of Ophthalmology, Kaiser Permanente, Oakland, California; ‡Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; §Department of Ophthalmology, Stanford University School of Medicine, Stanford, California; ¶The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California; and **West Coast Retina Medical Group, San Francisco, California. H IV/AIDS affects more than 2.5 million children younger than 15 years worldwide. 1 Approximately, 1,000 new children acquire HIV each day, most typically in utero or through maternal transmission through breast feeding. Ninety percent of HIV-infected children live in sub-Saharan Africa, and the majority of these are unaware of their infection. Ocular complications occur in more than 50% of untreated HIV-positive children. 1 Although both HIV- associated multifocal retinal infiltrates with phlebitis 2 and HIV-associated optic neuropathy 3–7 have been described in adults, they have not, to our knowledge, been described concurrently in pediatric patients. We describe a 15-year-old boy from Zimbabwe, Africa, who presented with bilateral multifocal retinal infil- trates with phlebitis and optic neuropathy in the setting of previously unrecognized HIV infection. Treatment with intravenous corticosteroids and highly active antiretroviral therapy (HAART) resulted in prompt resolution of inflammation and improvement in vision. Case Report A 15-year-old boy from Zimbabwe, Africa, with no significant medical history presented with a 7-day history of blurred vision in the right eye. His visual acuity was 20/100 in the right eye and 20/20 in the left. No afferent pupillary defect was noted. Anterior segment examination demonstrated mild anterior vitreous inflam- mation in each eye. Posterior segment examination revealed bilateral, multiple, and white intraretinal infiltrates and segmental Supported by That Man May See, Inc., and Research to Prevent Blindness (S. K. Kasi), The Pacific Vision Foundation (T. Martin, E. T. Cunningham), and The San Francisco Retina Foundation (E. T. Cunningham). None of the authors have any conflicting interests to disclose. Reprint requests: Emmett T. Cunningham, Jr., MD, PhD, MPH, West Coast Retina Medical Group, Inc., 1445 Bush Street, San Francisco, CA 94109; e-mail: emmett_cunningham@yahoo.com 311