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N. Takeda, S. Yashiro, A. Uemura; Ophthalmic Manifestations in Patients With Human Immunodeficiency Virus Infection in Japan. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5126.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze ophthalmic manifestations in patients with human immunodeficiency virus infection, who are increasing in Japan, in the HAART (highly active anti-retroviral therapy) era.
We retrospectively studied consecutive 1000 eyes and regions in 500 patients who made their first visit to Department of Ophthalmology, International Medical Center of Japan between August 2002 and December 2005.
The age ranged from 10 to 82-year-old and the mean age was 37.4 years. Thirties were 39.8%, twenties were 25.0% and forties were 18.8% of the patients. Regarding gender distribution, 91.0% of the patients were male and 9.0% of the patients were female. Thirties were the most affected age group in male (41.8%), but twenties were the most affected age group in female (40.0%). The number of CD4+ lymphocytes at the first visit was less than 200/µl in 48.3% of the patients and less than 50/µl in 18.5% of the patients. Ophthalmic manifestations were observed in 146 patients (29.2%), 237 eyes (regions) (23.7%). Retinal microvasculopathy (75 patients (15.0%), 118 eyes (11.8%)), cytomegalovirus (CMV) retinitis (31 patients (6.2%), 39 eyes (3.9%)), immune reconstitution syndrome including immune recovery uveitis (17 patients (3.4%), 23 eyes and region (2.3%)), iritis (13 patients (2.6%), 22 eyes (2.2%)) were frequent manifestations in turn. Other ophthalmic manifestations included keratitis and corneal infiltration, tuberculous uveitis, optic atrophy, papilledama, retinal vasculitis, Kaposi’s sarcoma, fundus lesion of unknown origin, dry eye, hemianopia and quadrantanopia, facial palsy, syphilitic uveitis, progressive outer retinal necrosis, Argyll Robertson pupil, bacterial endophthalmitis, papillitis, episcleritis, molluscum contagiosum, oculomotor palsy.
CMV retinitis, most vision threatening opportunistic infection, and various ophthalmic manifestations were still observed. In addition, immune reconstitution syndrome including immune recovery uveitis was observed after induction of HAART. Ophthalmic follow-up is important even in the HAART era.
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