Optic Neuropathy Associated With Cryptococcal Arachnoiditis in AIDS Patients

Optic nerve sheath fenestration in cryptococcal meningitis

“…Cryptococcal infection typically manifests as meningitis with secondary ocular involvement. Abnormal ocular fi ndings are seen in about 40% of the patients, with papilledema being the most common presenting sign (Lipson et al 1989).…”

“…The diagnosis of cryptococcal meningitis is suggested by a constellation of clinical and radiographic fi ndings and is supported by a diagnostic lumbar puncture. High opening pressure and the presence of cryptococcal antigen and organisms in cerebrospinal fl uid of affected patients are diagnostic of cryptococcal meningitis (Ofner and Baker 1987;Tan 1988;Lipson et al 1989;Garrity et al 1993).…”

“…Visual loss in cryptococcal meningitis may occur from chronically elevated intracranial pressure, adhesive arachnoiditis, or direct invasion of the visual sensory pathway by the organism (Kupfer and McCrane 1974;Ofner and Baker 1987;Tan 1988;Lipson et al 1989;Garrity et al 1993). Medical therapy with antifungal agents and surgical treatment, directed towards lowering the increased intracranial pressure, have met with variable success.…”

Ocular problems in AIDS

“…Infectious agents capable of producing intraocular infection in AIDS patients include cytomegalovirus [21], Cryptococcus neoformans [30], Pneumocystis carinii [41], Mycobacterium avium intracellulare [38], Toxoplasma gondii [19], Histoplasma capsulatum [31], and Candida albicans [44]. Cytomegalovirus infection of the retina is by far the most common opportunistic infection of the eye and the major cause of visual loss in AIDS patients in Europe and the United States.…”

Human immunodeficiency virus and bilateral optic atrophy

“…[1][2][3][4][5][6][7][8] Optic nerve abnormalities have been reported in HIV-infected individuals as a consequence of opportunistic infections. [9][10][11][12][13][14][15][16][17][18] However, neuro-ophthalmic manifestations of HIV have also been reported in the absence of associated opportunistic infections. [19][20][21][22] For instance, optic neuritis associated with a multiple sclerosis-like illness in the presence of HIV has also been described.…”