Ocular Manifestations of Acquired Immunodeficiency Syndrome

Kim, Young S.; Sun, Hae Jung; Kim, Tae Hyong; Kang, Kui Dong; Lee, Sung‐Jin

doi:10.3341/kjo.2015.29.4.241

Cited by 17 publications

(17 citation statements)

References 46 publications

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“…A large number of studies have been conducted on the observation of peripheral retinal conditions of fundus diseases through UWF laser scanning ophthalmoscopy [8] , aiming to reduce the burden of ophthalmic outpatient service by combining with optical coherence tomography for virtual retinal outpatient service [9] . With UWF fundus imaging, we confirmed that the most common HIV-related fundus changes were HIV-related MVR, followed by CMVR, which met the results of another group's study [3,10] . Other changes included HIV related/non-related lesions: optic disc edema, peripheral lattice degeneration, subretinal lesions, and PORN, etc.…”

Section: Discussionsupporting

confidence: 85%

“…Once an infectious retinitis appeared in AIDS patients, lesions would rapidly progress, causing irreversible vision loss or blindness. Nearly 19.7% to 44.25% of HIV/AIDS patients had fundus damages [2][3] . In the Post-HAART-Era, the most common fundus opportunistic infection is still cytomegalovirus retinitis (CMVR), which is also known as the main cause of vision loss in these patients.…”

Section: Introductionmentioning

confidence: 99%

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The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Chen

Guo

et al. 2019

Preprint

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Background: To observe the retinal lesions in HIV/AIDS patients and to evaluate the consistency of non-mydriatic ultra-wide-field (UWF) retinal imaging and mydriatic slit lamp biomicroscope with Superfield lens. Methods: 193 eyes of 98 consecutive HIV/AIDS patients were enrolled. The retinal lesions in each patients were observed through UWF fundus imaging and slit lamp biomicroscopic with Superfield lens whose consistency was analyzed. Results: 100 eyes (51.8%） had fundus lesions, 20 eyes (20%) presented posterior microvascular retinopathy (MVR), 19 eyes (19%) presented peripheral MVR, 15 eyes (15%) presented early stage cytomegalovirus retinitis (CMVR), 6 eyes showed initial stage CMVR, and 51 eyes showed other changes (papilledema, etc.). The consistency of two methods was moderate in detecting the isolated peripheral lesions (Kappa = 0.445) or HIV-related MVR (Kappa = 0.513), and high in inspecting the posterior/posterior involved lesions (Kappa = 0.831) or CMVR (Kappa = 1.0). The detection rate of UWF retinal imaging and slit lamp biomicroscopic were 15.5%（30/193）and 17.6%（34/193）(P=0.557＞0.05) for HIV-related MVR, 7.8% (15/193) (P=1.000＞0.05) for CMVR, 37.3% (72/193) and 33.7% (65/193) (P=0.118＞0.05) for posterior/posterior involved lesions, 8.8% (17/193) and 17.6% (34/193) (P=0.001＜0.05) for isolated peripheral lesions , respectively. Conclusions: The HIV-related MVR can be posterior or peripheral. Various fundus changes appear in HIV/AIDS patients, not only MVR or CMVR. The non-mydriatic UWF fundus imaging system and mydriatic slit lamp biomicroscope exhibited good consistency and nondiscriminatory detection rate for CMVR, HIV-related MVR and posterior lesions, but not for isolated peripheral lesions.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Chen

Guo

et al. 2019

Preprint

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“…Cited by many authors,7,8,10 a direct relationship of IOP with TCD4 in this study was not found, probably because the groups of patients with the virus under treatment were very homogeneous (well controlled of their disease) and the N of patients with the virus without treatment was small.…”

Section: Discussioncontrasting

confidence: 58%

<p>Intraocular pressure in patients with human immunodeficiency virus, correlation with TCD4, viral load and demographic characteristics: a case–control study</p>

Cravo

Biancardi

Ronconi

et al. 2019

OPTH

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Purpose To compare if patients with HIV have lower intraocular pressure than patients without HIV. Methods The association of intraocular pressure corrected by pachymetry and the relationship with viral load (VL) and TCD4 cells was studied. A total of 99 patients with HIV (91 who were on regular treatment and in control of the disease – group 1; and 8 who were without treatment – group 2) and 100 controls were studied. Results Only age was of statistical significance; the group with HIV without control of the disease was the youngest. There was a decrease of −1.54 mmHg in the IOP of group 1 in relation to the controls and −3.63 mmHg in the IOP of group 2 in relation to the controls. Conclusion HIV patients had lower IOP than the control population. However, the relationship between IOP, VL and TCD4 was not found.

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“…Similar to diabetes, HIV infection can cause various OMs, which have become a global health problem in patients with chronic diseases. Although the OMs prevalence has decreased compared to the pre-HAART era, as many as 48% of HIV-infected patients have been diagnosed with OMs in the HAART era [ 6 , 11 , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] ]. Early diagnosis of OMs is critical for the timely treatment and determination of the prognosis of HIV infection, as the impaired visual function can decrease productivity [ 9 , 17 , 18 , 23 , 24 ], and increase the cost of treatment [ 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

The value and implementation of routine ophthalmic examination in the era of HAART

Wang

Zhao

et al. 2021

EClinicalMedicine

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Background The high prevalence of ocular manifestations (OMs) in patients with human immunodeficiency virus (HIV) infection and chronic diseases such as diabetes has become a global health issue. However, there is still a lack of an appropriate ophthalmic diagnostic procedure for the early detection of OMs in this population, leading to the risk of an irreversible visual impairment that substantially affects the quality of life of these patients. Methods The Guangzhou HIV Infection Study was a retrospective study that enrolled hospitalised HIV-infected patients in Guangzhou between January 2005 and December 2016, period corresponding to the highly active antiretroviral therapy (HAART) era in China. We collected data on OMs, systemic diseases, hospitalisation, and demographic characteristics. We classified the patients into 3 groups according to the ophthalmic examination mode they underwent: the non-ophthalmologist examination group (patients hospitalised in 2005–2011 who were only treated by infectious disease physicians), the on-demand ophthalmic examination group (patients hospitalised in 2012–2013 who were referred for a consultation with an ophthalmologist), and the routine ophthalmic examination group (patients hospitalised in 2014–2016 who routinely underwent standard ophthalmic examinations). Binary logistic regression models were used to investigate the factors related to OMs. Findings A total of 8,743 hospitalised HIV-infected patients were enrolled. The prevalence of detected OMs were 1.5% in the non-ophthalmologist examination group, 1.9% in the on-demand ophthalmic examination group, and 12.8% in the routine ophthalmic examination group. The odds of detection of OMs were highest in the routine ophthalmic examination group (adjusted odds ratio [aOR]=9.24, [95%CI, 6.51–13.12], compared to the non-ophthalmologist examination group). The detection of all types of OMs increased substantially, with keratitis, retinitis and vascular abnormalities increased the most (by 15.8–20.0 times). In the routine examination group, patients who were older than 50 years, males, with medical insurance, and were not resident in Guangzhou, had higher odds to have OMs. Several systemic diseases also increased the odds of OMs, with the highest odds among patients with a cytomegalovirus infection (aOR=5.59, [95%CI, 4.12–7.59]). Patients with retinitis, retinopathy and conjunctivitis had higher odds of having a CD4 + T cell counts less than 200 cells/μL compared to the patients that did not have these referred OMs. Interpretation The implementation of a routine ophthalmic examination has improved the odds of OM detection by approximately 9 times and increased the diagnosis rates of all types of OMs. Therefore, we encourage all HIV-infected patients to undergo regular ophthalmic examinations. Patients with OMs, especially retinopathy and retinitis, need to be evaluated for immune function (such as ...

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Ocular Manifestations of Acquired Immunodeficiency Syndrome

Cited by 17 publications

References 46 publications

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

<p>Intraocular pressure in patients with human immunodeficiency virus, correlation with TCD4, viral load and demographic characteristics: a case–control study</p>

The value and implementation of routine ophthalmic examination in the era of HAART

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