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Vision recovery in human immunodeficiency virus-infected patients with optic neuropathy treated with highly active antiretroviral therapy: a case series.

Babu K, Murthy KR, Rajagopalan N, Satish B - Indian J Ophthalmol (2009 Jul-Aug)

Bottom Line: The above diagnosis was made by exclusion of infectious agents and neoplasms by detailed clinical and laboratory investigations.All patients had decreased visual acuity, pale optic discs and constriction of visual fields.Optic neuropathy in HIV-positive patients does not necessarily carry a poor prognosis even when a treatable cause is not found.

View Article: PubMed Central - PubMed

Affiliation: Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Center, 504 40th Cross, Jayanagar, Bangalore, India. kb_7375@yahoo.co.in

ABSTRACT
We describe three patients with bilateral, presumed human immunodeficiency virus (HIV)-induced optic neuropathy. The above diagnosis was made by exclusion of infectious agents and neoplasms by detailed clinical and laboratory investigations. All patients had decreased visual acuity, pale optic discs and constriction of visual fields. Improvement was documented in all three patients for visual acuity and in one patient for visual fields following treatment with highly active antiretroviral therapy (HAART). Optic neuropathy in HIV-positive patients does not necessarily carry a poor prognosis even when a treatable cause is not found. This article emphasizes the effectiveness of HAART in presumed HIV-induced optic neuropathy.

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Related in: MedlinePlus

Fundus photograph of case 1 showing optic disc pallor in right (a) and left (b) eye
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Figure 0001: Fundus photograph of case 1 showing optic disc pallor in right (a) and left (b) eye

Mentions: A 30-year-old retrovirus positive male was referred for a bilateral slowly deteriorating vision over a six-month period. His CD4 and absolute lymphocyte counts at the time of referral were 120 cells × 106/L and 2300 cells/mm3, respectively. At the time of presentation, he was on a combination of trimethoprim and sulphamethoxazole. BCVA was counting fingers at 1 meter in both eyes. Old visual fields two months prior to his referral showed constriction in both eyes. The optic discs were pale in both eyes [Figs. 1a and b]. There was no relative afferent pupillary defect. VEP showed decreased amplitude and increased latency in both eyes. At seven months follow-up, following HAART, his BCVA has improved to 20/60 and 20/40 in the right and left eyes respectively. The CD4 count at this follow-up was 210 cells × 106/L.


Vision recovery in human immunodeficiency virus-infected patients with optic neuropathy treated with highly active antiretroviral therapy: a case series.

Babu K, Murthy KR, Rajagopalan N, Satish B - Indian J Ophthalmol (2009 Jul-Aug)

Fundus photograph of case 1 showing optic disc pallor in right (a) and left (b) eye
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2712706&req=5

Figure 0001: Fundus photograph of case 1 showing optic disc pallor in right (a) and left (b) eye
Mentions: A 30-year-old retrovirus positive male was referred for a bilateral slowly deteriorating vision over a six-month period. His CD4 and absolute lymphocyte counts at the time of referral were 120 cells × 106/L and 2300 cells/mm3, respectively. At the time of presentation, he was on a combination of trimethoprim and sulphamethoxazole. BCVA was counting fingers at 1 meter in both eyes. Old visual fields two months prior to his referral showed constriction in both eyes. The optic discs were pale in both eyes [Figs. 1a and b]. There was no relative afferent pupillary defect. VEP showed decreased amplitude and increased latency in both eyes. At seven months follow-up, following HAART, his BCVA has improved to 20/60 and 20/40 in the right and left eyes respectively. The CD4 count at this follow-up was 210 cells × 106/L.

Bottom Line: The above diagnosis was made by exclusion of infectious agents and neoplasms by detailed clinical and laboratory investigations.All patients had decreased visual acuity, pale optic discs and constriction of visual fields.Optic neuropathy in HIV-positive patients does not necessarily carry a poor prognosis even when a treatable cause is not found.

View Article: PubMed Central - PubMed

Affiliation: Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Center, 504 40th Cross, Jayanagar, Bangalore, India. kb_7375@yahoo.co.in

ABSTRACT
We describe three patients with bilateral, presumed human immunodeficiency virus (HIV)-induced optic neuropathy. The above diagnosis was made by exclusion of infectious agents and neoplasms by detailed clinical and laboratory investigations. All patients had decreased visual acuity, pale optic discs and constriction of visual fields. Improvement was documented in all three patients for visual acuity and in one patient for visual fields following treatment with highly active antiretroviral therapy (HAART). Optic neuropathy in HIV-positive patients does not necessarily carry a poor prognosis even when a treatable cause is not found. This article emphasizes the effectiveness of HAART in presumed HIV-induced optic neuropathy.

Show MeSH
Related in: MedlinePlus