The Spectrum of Optic Nerve Disease in Human Immunodeficiency Virus Infection

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.…”

“…However, the majority of optic nerve disease seen in HIVinfected patients occurs as a result of secondary infections. Winward et al, 9 for example, describe four patients with neuro-ophthalmic dysfunction from a variety of secondary infections including syphilis, cytomegalovirus, varicella zoster, and cryptococcal infections. They also describe a spectrum of optic neuropathies seen in association with HIV infection, mainly optic perineuritis, papillitis, retrobulbar neuritis, and papilledema.…”

“…They also describe a spectrum of optic neuropathies seen in association with HIV infection, mainly optic perineuritis, papillitis, retrobulbar neuritis, and papilledema. 9 Previous case reports of optic neuropathies in the setting of HIV infection describe optic nerve edema at presentation. Although some reports describe a progression of optic nerve edema to optic pallor, 9,19,20,23 no reports describe a patient with optic atrophy at presentation.…”

“…9 Previous case reports of optic neuropathies in the setting of HIV infection describe optic nerve edema at presentation. Although some reports describe a progression of optic nerve edema to optic pallor, 9,19,20,23 no reports describe a patient with optic atrophy at presentation. Friedman 24 mentions two patients with retrobulbar neuritis and cytomegalovirus retinitis who developed optic atrophy associated with visual loss, but specific examples were not cited.…”

“…Friedman 24 mentions two patients with retrobulbar neuritis and cytomegalovirus retinitis who developed optic atrophy associated with visual loss, but specific examples were not cited. Winward et al 9 comment on the possibility of developing optic atrophy and visual loss from cytomegalovirus retinitis alone, but again specific examples of patients are not provided. Berger et al 23 describe seven patients with HIV and a multiple sclerosis-type illness.…”