Bull ́s Eye Maculopathy in a patient treated with efavirenz

Pereira, Cristina Vaz; Franco, Mónica; Pinto, Rita; Barrão, Sandra; Filipe, Helena Prior

doi:10.48560/rspo.6860

Cited by 1 publication

(1 citation statement)

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“…An earlier review by Abers et al 17 found that zidovudine, abacavir, efavirenz, didanosine, stavudine, and ritonavir were responsible for mitochondrial dysfunction which manifested as damage to the RPE and with macula telangiectasias and intraretinal crystalline deposits. A case report by Pereira et al 18 also found atrophy of macula RPE (Bull's eye maculopathy) in a patient on efavirenz for 10 months. Although they did not report on the mechanism of toxicity, they postulate that an increased plasma concentration of the drug may cause retinal changes.…”

Section: Mechanisms Of Art-induced Retinal Toxicity Cellular Neuro-in...mentioning

confidence: 89%

Inflammatory mechanisms contributing to retinal alterations in HIV infection and long-term ART

Buthelezi,

Munsamy,

Mashige

2024

Southern African Journal of HIV Medicine

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People living with HIV (PLWH) may face an increased risk of eye complications associated with ageing, chronic inflammation, and the toxicity arising from long-term antiretroviral therapy (ART). This review aims to understand how inflammatory pathways contribute to retinal alterations observed in PLWH on long-term ART. This review was conducted using four electronic database searches, namely Scopus, Hinari, Google Scholar, and PubMed; from 1996 (when ART became available) until January 2022, without language restriction. Sources from clinical trials, meta-analyses, randomised controlled trials, and systematic reviews were used. Dysregulated para-inflammation (chronic inflammation) damages the blood-retina barrier, resulting in the altered retinal immune privilege and leading to the development of retinal and blood vessel changes. There is an interplay between the effects of the disease versus ART. ART causes mitochondrial toxicity, which affects the retinal ganglion cells and retinal pigment epithelium (RPE) due to oxidative stress. Infection by HIV also affects retinal microglia, which contributes to RPE damage. Both of these mechanisms affect the blood vessels. Assessing the integrity of the inner and outer blood-retina barrier is a pivotal point in pinpointing the pathogenesis of inner retinal alterations. Optical coherence tomography is a valuable tool to assess these changes. There is a paucity of research to understand how these structural changes may affect visual function, such as contrast sensitivity and colour vision.

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Section: Mechanisms Of Art-induced Retinal Toxicity Cellular Neuro-in...mentioning

confidence: 89%