Ocular manifestations in HIV patients attending a tertiary care hospital in Eastern India and correlation of posterior segment lesions with CD4+ counts.

PURPOSE: We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts. METHODS: This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case. RESULTS: A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30-39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001). CONCLUSION: Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections.

Pseudo endophthalmitis following intravitreal triamcinolone acetonide for cystoid macular edema in a post-vitrectomised eye.

Post-operative endophthalmitis is a vision threatening complication following intraocular surgery requiring prompt treatment. Clinical picture mimicking infectious endophthalmitis can rarely be produced following intravitreal triamcinolone acetonide injection. A 65-year-old male with previous history of pars plana vitrectomy and lens removal was diagnosed with post-operative cystoid macular edema in his right eye. He received intravitreal triamcinolone acetonide injection in his right eye. Two days following the injection he complained of further reduction in vision and presented with a clinical picture resembling infectious endophthalmitis. Nil active intervention was done. There was significant improvement in vision one week following the injection. Ophthalmologists should be aware of this clinical scenario so that excessive and unwarranted treatment can be avoided.