AIDS and eye problem

1

AIDS

CD4+ T lymphocytes <500/ml; Kaposi Sarcoma, TB

CD4+ T lymphocytes <250/ml; toxoplasmosis

CD4+ T lymphocytes <50/ml; CMV retinitis

Kaposi Sarcoma

TB uveitis

Toxoplasmosis

CMV retinitis

Herpes zoster ophthalmicus

Candida endophthalmitis

By: ismah haron

2

KAPOSI SARCOMA

Painless vascularized tumor – herpesvirus type 8

Eyelid skin, eyelid margin & conjunctiva

Slow growing & rarely invasive

Rx: exision/ focal radiation theraphy

Indication for rx: cosmetic/ disturb vision

25% in HIV patients

3

TB UVEITIS

Anterior uveitis

Photophobia, tearing, eye pain, decreased

vision

Accompanied by constitutional symptoms of

TB

Culture for M. tuberculosis

Anti TB drugs

4

TOXOPLASMOSIS

T. gondii remains within an inactive

chorioretinal scar

Reactivation in HIV – toxoplasmic

chorioretinitis

Serology detection via indirect

hemagglutination assay

5

CMV RETINITIS

Reactivation of CMV, 5 to 10% of AIDS patients in

developing countries

Floaters, photophobias, visual loss w/o eye pain or

red eye

Rapidly progressive (destroyed the whole retina

within 6 months)

Cx: RV/RA occlusion and retinal detachment

Ix: + conjunctival swab, PCR to confirm

Rx: drugs – ganciclovir, foscarnet (IVOral, SE?)

6

7

HERPES ZOSTER OPHTHALMICUS

Reactivation of VZV infection

5 to 15 % of HIV patients

Can affect either eyelids, cornea,

sclera, iris, retina

Vesicular rashes burst crusting

ulcers

Rx: IV/ oral acyclovir, gentian violet

1% bd

8

9

CANDIDA ENDOPHTHALMITIS

Candida Albicans

Symptoms: red eye, scotoma, floaters, eye

pain, photophobia

Fundoscopy: Fluffy white retinal lesion with

white snowball-like vitreous opacities

Anti fungal e.g. amphothericin BTHANK YOU