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Intraocular crystals in HIV-related hypergammaglobulinemia
Andrew Traill1, Ehud Zamir, Darren Russell
1The Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Purpose:
To describe the occurrence of bilateral iris and retinal crystals in a patient with benign HIV-related gammopathy.
Design:
Observational case report.
Methods:
A 45-year-old HIV-positive male with a known, benign hypergammaglobulinemia was referred for routine ophthalmic assessment because of right ophthalmic zoster.
Results:
Ophthalmoscopic examination revealed the presence of bilateral, multiple, refractile iris and macular crystals. No other signs of uveitis or stigmata of HIV were found.
Conclusion:
Intraocular crystals are a rare finding, usually seen in chronic uveitis with or without hypergammaglobulinemia. This finding has not been previously described in non-inflamed eyes, nor as an ocular manifestation of HIV. We hypothesize that HIV-related disruption of the blood-aqueous and blood-retinal barriers allows intraocular immunoglobulin deposition in patients with hypergammaglobulinemia.
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