The purpose of the study was to determine the prevalence of ocular diseases in human immunodeficiency virus (HIV) patients in Washington, DC in the era of highly active antiretroviral therapy (HAART). This was a cross-sectional study of patients with HIV who were seen by the ophthalmology consultation service between September 2003 and May 2011 at a single academic institution in Washington, DC. Medical history and ophthalmic findings were reviewed. Patients with complete laboratory data dated within 3 months of their presenting eye examination were included. Descriptive statistics were performed. The records of 151 patients were included in the final analysis. All patients had complete laboratory data dated within 3 months of their presenting eye examination. Sixty-eight (45 %) patients and fifty-eight (50 %) of those with a diagnosis of acquired immune deficiency syndrome (AIDS) were diagnosed with an HIV-related ophthalmic disease. The leading anterior segment disease was herpes zoster ophthalmicus and the leading posterior segment disease was HIV retinopathy. Of the 151 included patients, 78 (52 %) were receiving HAART at the time of the examination. Thirty-one (42 %) of those not receiving HAART were diagnosed with an HIV-related ophthalmic disease. In this study, we find that the overall prevalence of ocular disease has decreased since the introduction of HAART. However, HIV patients continue to be predisposed to developing ophthalmic disease at higher rates than the general population. Visual dysfunction remains an important source of morbidity in HIV patients, particularly in those with AIDS. Measures for improvement include increased communication between infectious disease specialists and ophthalmologists to ensure adherence to HAART and routine eye examinations.
A case of migraine headache triggered by intravitreal injection, and aborted by retrobulbar injection, is reported. To date, migraine and related cephalgia have not been reported after intravitreal injection. Ophthalmologists and neurologists should be aware of this potential sequela of a very common procedure.
To report a case of sequential bilateral inferior retinal detachments secondary to inversion table therapy.A 67-year-old-male developed inferior rhegmatoegnous retinal detachments (RRD) in both eyes on two different occasions with the use of inversion therapeutic tables.Various predisposing factors have been documented for RRD such as previous cataract surgery, peripheral retinal degenerations, high myopia, history of previous retinal detachments and direct ocular trauma. The authors report here a case of inferior retinal detachments associated with the use of inversion therapy. Physical therapists, physical medicine rehabilitation physicians, and retinal specialists need be aware of this potential complication.
We report a case of bilateral superior altitudinal hemianopsia (BSAH) secondary to pituitary microadenoma related inferior optic chiasm damage. A 69-year-old-female developed a BSAH with macular involvement that was initially considered as malingering due to the obscurity of this symptom. The patient presents with multiple risk factors for ischemic disease to the ocular and occipital vessels, persistent migraine, hypothyroidism, and a stable pituitary microadenoma, yet no evidence of tissue ischemia or infarction was noted on imaging that could account for her visual field defects. A prior history of pituitary microadenoma is presumed to be the etiologic cause although the lesion had regressed by the time of presentation.
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