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Shanti Gurung, Prof. DN Shah, Prof AK Sharma, Prof Dr Laxman Shrestha, Dr Madhu Thapa, Dr Manita Godar; Ocular Manifestations of HIV/AIDS in Children and Adults. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2156.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular involvement in HIV/AIDS cases occurs in about 70% of patients leading to various ocualr morbidity and blindness. In Nepal burden of HIV disese is high but there is paucity of information and knowledge concerning ocular manifestations in both chidren and adults. We performed a cross-sectional descriptive study to document different ocular manifestations in both children and adults.
We analyzed 18 months data from a cross-sectional descriptive hospital based study. Children and adults living with HIV and AIDS were examined for ocualr disease and its complications. We had excluded those patients without CD4 count and who were very sick and not able to perform detailed examination. Detailed history and examination datas were recorded in a proforma designed for the study analyzed using SPSS version 19.
Of 114 cases (54 children and 60 adults),24% of children and 61.9% of the adults had developed ocular manifestations.Anterior segment and external ocular disorders comprised 21% of the cases in this study. The most common finding was herpes simplex blepharoconjunctivitis (11.1%) in 7 children and dry eye (8.3%) and herpes zoster ophthalmicus (2.6%) in adults. Posterior segment manifestations comprised 34% of the cases in this study, (HIV retinopathy-13.5%, CMV retinits-10.8%, Retinal detachment-8.1%, Mulitifocal Choroiditis (with PTB)-2.7% and ocular Toxoplasmosis-2.7%) were seen in adults. Among children, one each case of CMV Retinitis, optic atrophy, macular edema, ocular toxoplasmosis, and herpes zoster ophthalimicus and disc edema were seen.No cases of HIV Retinopathy seen in pediatric age groups. Regarding neuro-ophthalmic manifestation it comprises 18.9% in adult and 15.3% in children.
The pattern of ocular involvement seen in HIV infected cases is similar to what we see in this subcontinent but different from that in developed countries. Our data, in agreement with other series reported in the literature, indicate that cotton-wool spots (HIV Retinopathy) and CMV retinitis, the most common ocular manifestations of HIV/AIDS in adults, are much less prevalent in children. Instead blepharoconjunctivitis was commonest ocular findings in our patients; ocular opportunistic disease and neuro-ophthalmic manifestation were seen in our pediatric cases.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
CMV Retinitis in 18 years male with CD4+ count of 23cells/ul.
Distribution according to ocular disease and CD4+ count in children.
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