Progressive Multifocal Leukoencephalopathy (PML) in Two Cases of Cortical Blindness

Haemorrhagic acute disseminated encephalomyelitis: an unusual case of blindness in an HIV-infected patient

“…Presentation with acute onset blindness is rare in HIV-positive patients. The few causes reported include primary CNS lymphoma involving optic chiasma, 4 retrobulbar optic neuritis due to varicella zoster preceding the retinal changes, 5 PML resulting in cortical blindness, 6 chiasmal infarction due to mucormycosis, 7 optic neuritis caused by Histoplasma capsulatum 8 and AIDS-related optic neuropathy. 9 Our case illustrates the importance of considering ADEM, both conventional and haemorrhagic forms, in the differential diagnosis of HIV-infected patients presenting with sudden bilateral loss of vision with a normal retina.…”

Noncompaction in a HIV-positive with cortical blindness as initial manifestation of progressive multifocal leucencephalopathy

“…PML is associated with HIV-infection in up to 86% of the cases [2], but occasionally occurs together with transplanted patients [3,4], or in patients under an immune-modulating therapy with natalizumab or rituximab [4,5]. Though PML has been reported to manifest with visual impairment [1,3,[6][7][8][9][10][11] or as bilateral visual loss as the presenting manifestation in single patients [3,8], it has not been described in association with left ventricular-hypertrabeculation (LVHT)/noncompaction [12].…”

“…Visual failure was also reported as the initial manifestation of PML in a heart-transplant-recipient who died two months later [8]. Cortical blindness was additionally reported in two other cases with PML [11]. Blurred vision together with hemiparesis and ataxia were also the initial manifestations of PML in a HIV-infected female with an enhancing lesion in the left middle cerebellar peduncle on MRI [13].…”