Background: Ocular involvement is a common complication of human immunodeficiency virus (HIV). Knowledge about this topic in Tunisia is limited.Objective: To investigate ophthalmic manifestations in patients living with HIV in Tunisia.Method: This was an observational study, performed between January 2007 and December 2016. We included patients with ocular disorders related to HIV. The data were recorded retrospectively from chart review.Results: Amongst 98 people living with HIV (PLWH), 36 participants (55 eyes) had ocular manifestations. The mean age was 32.2 ± 5.6 years. Twenty-four patients were men and 12 were women. The mean value of CD4+ T-cell count was 156.5 ± 4.2 cells/µL. Bilateral lesions were found in 19 eyes. Best corrected visual acuity was better than 6/12 in 36 eyes. The most common ocular finding was dry eye syndrome (22%), cotton-wool spots (20%) and retinal haemorrhage (16%) followed by cytomegalovirus (CMV) retinitis (9%), anterior uveitis (7%), toxoplasmosis (4%) and tuberculosis retinochoroiditis (7%) Herpetic keratitis (5%), Herpes zoster ophthalmicus (2%) and syphilitic chorioretinitis (2%). Papilledema was found in three eyes (5%). Panuveitis was observed in four eyes (7%): three of them were associated with chorioretinal toxoplasmosis, syphilitic chorioretinitis and CMV retinitis. The fourth was attributable to immune recovery uveitis. A CD4+ T-cell count of ≤ 200 cells/µL was found to be an independent risk factor for developing posterior segment manifestations.Conclusion: Various ophthalmic manifestations were observed in PLWH. The most common lesion was retinopathy. Ocular involvement can be serious leading to poor visual prognosis, which requires close collaboration between the ophthalmologist and infectious disease physician.
Background: Behçet’s disease is frequent in Tunisia and potentially serious which it can endanger both the vital and visual prognosis. Late occurrence of the disease is uncommon and less frequently investigated. Aims: The aim of this study was to analyse the demographic characteristics and ocular manifestations of patients with late-onset Behçet disease in Tunisia, North Africa. Methods: A retrospective study was performed on 38 eyes of 21 oculo-Behçet patients over a seven-year period. Results: The mean age of our patients was 54.81 years. The sex ratio M/F was 2.5. The period between onset of the first symptom and diagnosis of Behçet’s disease varied from 3 days to 2 years. The primary complaint was decrease of visual acuity reported in 8 patients. Ocular involvement was revealing of Behçet’s disease in 2 patients, bilateral in 17 patients and active in 31 eyes. The ocular manifestations in late-onset Behçet’s disease were dominated by uveal involvement (30 eyes). The most frequent form of uveitis was panuveitis noted in 13 eyes. Ocular complications were dominated by macular involvement in 8 patients (14 eyes). Blindness was noted in 4 eyes of 4 patients (10.5%). Topical corticosteroids were used in 30 eyes. Three patients were treated only with oral corticosteroid and 9 patients with a combination of oral corticosteroid and immunosuppressive agents. Conclusion: Since the course of the ocular involvement in late-onset Behçet’s disease is regarded to be relatively mild, it is noteworthy that our study revealed that blindness was noted in 10,5% and posterior uveitis and panuveitis were the most common uveal lesion.
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