MRCP2-0775

MRCP2-0775

A 50-year-old woman presents with fever, night sweats, and weight loss. She has a medical history of type 1 diabetes and was recently found to have microaneurysms and dot and blot haemorrhages on retinal screening. Despite no previous visual problems, she is admitted to the hospital and diagnosed with HIV with a CD4 count of 140 cells/µL. After starting treatment with Rifampicin, Isoniazid, Pyrazinamide, ethambutol, pyridoxine, cotrimoxazole, and antiretroviral therapy with Efavirenz, emtricitabine, and tenofovir, she is discharged and makes a good recovery. However, a few months later, she reports increasingly blurry vision, and fundoscopy reveals pale optic discs, microaneurysms, and blot haemorrhages. What is the most likely cause of her visual symptoms?