Ocular findings in human immunodeficiency virus patients in Washington, DC

Kaleem, Mona; Ramsahai, Shweta; Fierro, Katrina del; Rasul, Samad; Onumah, Chavon; Lerebours, Valerie; Gajjala, Jhansi; Copeland, Robert A.; Jones, Leslie S.

doi:10.1007/s10792-012-9543-3

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Orbital and adnexal manifestations of HIV are rare, with Kaposi sarcoma, conjunctival microvasculopathy and opportunistic viral infections being the most common .…”

Section: Hiv and The Eyementioning

confidence: 99%

Viral ocular manifestations: a broad overview

Newman

Gooding

2013

Reviews in Medical Virology

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The viruses able to affect the eye are taxonomically diverse, ranging from double-stranded DNA viruses, to single stranded RNA viruses, to retroviruses. Any part of the eye may be affected, frequently producing blepharitis, conjunctivitis, keratitis, uveitis, cataract and retinitis. The more common ocular viral infections include the Herpesviruses such as HSV-1, VZV and CMV. The HIV pandemic is placing a serious burden on ophthalmology clinics, particularly in sub-Saharan Africa as the number of viral ocular diseases is increasing. In particular, CMV retinitis is becoming more prevalent where antiretroviral therapy is not available and is replaced by immune-recovery uveitis where antiretrovirals are given. This review aims to improve knowledge of the common viral ocular diseases, their diagnosis and management, as well as the fairly uncommon viral ocular diseases that may also cause considerable morbidity.

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“…Orbital and adnexal manifestations of HIV are rare, with Kaposi sarcoma, conjunctival microvasculopathy and opportunistic viral infections being the most common .…”

Section: Hiv and The Eyementioning

confidence: 99%

Viral ocular manifestations: a broad overview

Newman

Gooding

2013

Reviews in Medical Virology

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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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“…However, many patients are still diagnosed of advanced HIV-1 infection, with concurrent opportunistic infections [ 2 , 3 ]. HIV-1-infected patients are prone to develop ocular opportunistic infections, such as cytomegalovirus (CMV) retinitis, cryptococcosis, toxoplasmosis, and tuberculosis [ 4 – 6 ]. HIV retinopathy can also occur in patients with HIV-1 infection [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Routine Eye Screening by an Ophthalmologist Is Clinically Useful for HIV-1-Infected Patients with CD4 Count Less than 200 /μL

et al. 2015

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ObjectiveTo investigate whether routine eye screening by an ophthalmologist in patients with HIV-1 infection is clinically useful.MethodsA single-center, retrospective study in Tokyo, Japan. HIV-1-infected patients aged over 17 years who visited our clinic for the first time between January 2004 and December 2013 and underwent full ophthalmologic examination were enrolled. At our clinic, ophthalmologic examination, including dilated retinal examination by indirect ophthalmoscopy was routinely conducted by ophthalmologists on the first visit. The prevalence of ophthalmologic diseases and associated factors including the existence of ocular symptoms were analyzed.ResultsOf the 1,515 study patients, cytomegalovirus retinitis (CMV-R) was diagnosed in 24 (2%) patients, HIV retinopathy (HIV-R) in 127 (8%), cataract in 31 (2%), ocular syphilis in 4 (0.3%), and uveitis with unknown cause in 8 (0.5%). Other ocular diseases were diagnosed in 14 patients. The CD4 count was <200 /μL in all CMV-R cases and 87% of HIV-R. The prevalence of any ocular diseases, CMV-R, and HIV-R in patients with CD4 <200 /μL were 22%, 3%, and 15%, respectively, whereas for those with CD4 ≥200 /μL were 5%, 0%, and 2%, respectively. No ocular symptoms were reported by 71% of CMV-R cases and 82% of patients with any ocular diseases.ConclusionsRoutine ophthalmologic screening is recommended for HIV-1-infected patients with CD4 <200 /μL in resource-rich settings based on the high prevalence of ocular diseases within this CD4 count category and because most patients with ocular diseases, including those with CMV-R, were free of ocular symptoms.

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Ocular findings in human immunodeficiency virus patients in Washington, DC

Cited by 10 publications

References 9 publications

Viral ocular manifestations: a broad overview

Viral ocular manifestations: a broad overview

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

Routine Eye Screening by an Ophthalmologist Is Clinically Useful for HIV-1-Infected Patients with CD4 Count Less than 200 /μL

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