Human immunodeficiency virus-associated blepharoptosis.
Ophthalmic Plast Reconstr Surg
; 27(5): 360-3, 2011.
Article
in En
| MEDLINE
| ID: mdl-21743372
ABSTRACT
PURPOSE:
To better characterize an unusual blepharoptosis observed in HIV-positive patients and to evaluate histopathology.METHODS:
This retrospective case series evaluated patients with HIV/AIDS and blepharoptosis with reduced levator excursion. Exclusion criteria included patients with identifiable causes of ptosis (e.g., aponeurotic dehiscences, prior eyelid trauma or surgery), known myopathic/neuropathic systemic disorders, congenital ptosis, cranial neuropathies, and systemic infiltrative processes.RESULTS:
All 10 patients had bilateral symptomatic blepharoptosis. All patients (100%) were men with a mean age at presentation of 54 years (range, 42-77 years). Mean duration of HIV infection among 7 of 10 patients was 19 years (range, 13-24 years). Mean (±SD) MRD1 was 0.7 (±0.8) OD and 0.6 (±0.8) OS. Mean (±SD) levator excursion was 12 (±2.3) OD and 13 (±1.8) OS (normal levator excursion >15 mm). No patient was taking zidovudine (AZT) at the time of presentation. Nine patients (90%) underwent large bilateral levator resections for correction of blepharoptosis. Histopathologic specimens revealed abnormal levator muscle fibers with various degrees of atrophy, fibrosis, and regeneration without inflammation.CONCLUSIONS:
The HIV-associated blepharoptosis observed among patients in this study is most consistent with a myopathy. Levator muscle histopathologic findings are virtually identical to muscle biopsies in individuals with HIV-associated myopathy, described before the advent of AZT or highly active antiretroviral therapy (HAART). Surgical management with levator resection provides optimal correction of HIV-associated blepharoptosis.
Full text:
1
Database:
MEDLINE
Main subject:
Blepharoptosis
/
HIV Infections
/
HIV
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2011
Type:
Article