[Ocular manifestations of AIDS in Dakar]. / Manifestations oculaires au cours du SIDA à Dakar.

ABSTRACT

In this prospective study undertaken between november 1989 and december 1991, the authors report their observations of ocular lesions seen in a cohort of 67 AIDS patients hospitalised in the Infectious Diseases department CHU Fann Dakar. Ocular lesions were discovered in 52.23%. These lesions were observed in both HIV-1 and HIV-2 positive patients, however they were much more common in the former group (77.14%). Rétinal pathology was by far the most frequently observed (63%) and yet classic retinis was not discovered in our series. We feel that the ophtalmologist should play a key role in the routine care of AIDS patients especially in surveillance of retinal changes.

ABSTRACT

PIP During November 1989 to December 1991 in Senegal, physicians regularly followed 67 HIV infected patients aged 20-76 (46 men and 21 women) who had been admitted to Fann University Hospital in Dakar. The HIV infection had progressed to AIDS in all but one case. 52.33% had ocular lesions, of which the most frequent were cotton-like nodules (14.2%), retinal bleeding and Roth's spots (8.5%), and ophthalmic herpes zoster (8.5%). Most lesions (63%) were located in the retina. Yet, there were no cases of classic retinitis. Among 21 AIDS patients with a known lymphocyte count, 62.5% of those with a CD4 count of less than 200 had a normal ophthalmological examination. Patients with CD4 counts between 0 and 200 had macular edema, hyalitis, cotton-like nodules, retinal uveitis, and microangiopathy, while those with higher CD4 counts had none of these ocular lesions. Patients with CD4 counts greater than 400 had conjunctivitis (one case, Kaposi sarcoma-related conjunctivitis), ophthalmic herpes zoster, and ocular dryness. The only ocular lesion in patients with CD4 counts between 200 and 400 was ophthalmic herpes zoster. 77.14% of HIV infected patients with ocular lesions were infected with HIV-1. The three ophthalmic herpes zoster cases were less than 30 and homosexual. During the two years of follow-up, only one case died. Based on these findings, the authors suggest that ophthalmologists should systematically be involved in the routine care of AIDS patients, particularly by screening for changes in the retina.