Epidemiology of the Ocular Complications of HIV Infec tion in Chiang Mai
SOMSANGUAN AUSAYAKHUN, MD, MHSc*, SOPA WATANANIKORN, MD*, NIMITR ITTIPUNKUL, MD*, WINAI CHAIDAROON, MD*, PRAPATSORN PATIKULSILA, MD*, DIREK PATIKULSILA, MD*
Affiliation : *Department of Ophthalmology. Faculty of Medicine. Chiang Mai University, Chiang Mai 50200, Thailand.
Objective : To identify the magnitude of ocular complications in HIV infection in Chiang Mai, and determine the signs or symptoms that indicate the risk factors for developing ocular compli cations in HIV -positive patients
Method : A prospective study was carried out in newly diagnosed HIV-positive patients seen in the Ocular Infectious Disease Clinic of Maharaj Nakom Chiang Mai Hospital from March I, 2000 through February 28, 200 I. A complete ophthalmic examination was performed on each patient together with a systemic evaluation of present illness and current medications.
Results : Three-hundred and ninety-five HIV -positive patients were seen for ophthalmic evaluation. Of these, 90 were in stage A (asymptomatic), 84 were in stage B (symptomatic), and 221 were in stage C (AIDS). Ocular complications were found in 44.6 per cent of the patients. Cytomegalo virus (CMV) retinitis was the most common ophthalmic complication (33%). Other ocular complica tions included cotton wool spot (8% ), uveitis (4% ), optic neuropathy (3% ), and keratoconjunctivitis sicca (2%). The clinical presenting symptoms, which were the indicators for ocular complications and CMV retinitis, included chronic cough, oral thrush, chronic diarrhea, weight loss, wasting, and skin dis orders. Ocular symptoms, which indicated a high risk of developing CMY retinitis, included flashing, floaters, and scotoma.
Conclusions : Ocular complications are common in HIV-positive patients. CMY retinitis. which is a major vision-threatening problem, represented the most common finding. It is recommended that HIV-positive patients should have their eyes examined regularly, particularly when they have the clinical presenting symptoms previously mentioned. The patients should also notice early symptoms of CMV retinitis, which includes flashing, floaters, and scotoma.
Keywords : HIV, Eye Complications, CMV Retinitis
