Uveitis as an initial manifestation of acquired immunodeficiency syndrome

Abstract

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a multisystem disease that can involve the human eyes. Using ophthalmic examination records from January 2006 to November 2015, we retrospectively reviewed all patients who were diagnosed with HIV/AIDS in our hospital. The study was performed at a tertiary referral center in southern Taiwan. Data included age, gender, ophthalmic examinations, systemic conditions, CD4 cell counts, course, and treatment. Eleven patients were identified as having AIDS with uveitis as their presenting manifestation. All were men, with a mean age of 39.5 ± 11.4 years (range 24-56). The mean CD4 T-cell counts were 91.7 ± 50.3 cells/μl (range 27-169). Ocular diagnoses included cytomegalovirus (CMV) retinitis in five patients, ocular syphilis in four patients, and ocular toxoplasmosis in two patients. Uveitis resolved in all patients after medical treatment. However, a retinal detachment developed in two eyes in CMV retinitis and one eye in ocular syphilis. Ocular manifestations are among the most common clinical features in patients with HIV/AIDS who have varying clinical presentations that affect almost all ocular structures. This study demonstrated that ocular findings could be an initial manifestation of an underlying disease. Awareness of ocular lesions in HIV/AIDS is important for early recognition and management.

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

“…The true rate of ocular syphilis may be higher than we have reported, because patients with mild visual symptoms may not have been detected by either the clinician or the patient themselves. Whilst ocular syphilis is a treatable disease if it is diagnosed promptly and treated properly delays can lead to serious sequelae including lifelong blindness [24][25][26] . In the pre-antibiotic era, about 9% to 12% of patients with ocular syphilis developed blindness.…”

Double Morphology: Tertiary Syphilis and Acquired Immunodeficiency Syndrome—A Rare Association

“…In the presence of HIV infection syphilis can appear at any stage. The eye changes of syphilis can involve any structure of the eye with uveitis being the initial manifestation in patients who have acquired immunodeficiency syndrome [ 6 ]. Panuveitis is common in patients who are HIV infected [ 7 ].…”

Interleukin-1A May Illuminate Differential Effects of the Retinal Artery Caliber in HIV Patients

“…Microvascular disease is a common complications that affects the eyes in human immunodeficiency virus (HIV) patients, and can impair visual function as well. 1,2 We have shown that retinal artery caliber (RAC) is narrower in HIVinfected patients beginning antiretroviral therapy (ART) than healthy controls and narrows further over time. 3 Population-based studies link narrow RAC with higher current mean blood pressure, male sex, higher risk of chronic kidney disease and stroke mortality in persons with diabetes.…”