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A multicenter study of Pneumocystis choroidopathy
M J Shami1, W Freeman, D Friedberg
1Department of Ophthalmology, Pacific Presbyterian Medical Center, San Francisco, California.
American Journal of Ophthalmology
|July 15, 1991
Summary
Pneumocystis choroidopathy, a complication in AIDS patients, presents as yellow lesions in the eye. Early detection via ocular exams can indicate disseminated Pneumocystis infection and assess prophylaxis effectiveness.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Acquired immunodeficiency syndrome (AIDS) patients are susceptible to opportunistic infections.
- Pneumocystis pneumonia (PCP) prophylaxis is standard, but extrapulmonary disease can still occur.
- Pneumocystis carinii choroidopathy is a rare ocular manifestation of disseminated Pneumocystis infection.
Purpose of the Study:
- To describe the clinical characteristics of Pneumocystis carinii choroidopathy in AIDS patients.
- To evaluate the relationship between choroidopathy and Pneumocystis pneumonia prophylaxis.
- To assess the diagnostic and prognostic value of choroidopathy in disseminated Pneumocystis infection.
Main Methods:
- Retrospective study of 21 AIDS patients with presumed Pneumocystis carinii choroidopathy.
- Clinical examination including visual acuity and visual field testing.
- Review of treatment regimens and patient outcomes.
Main Results:
- Characteristic yellow choroidal lesions were observed in the posterior pole.
- Lesion size varied (300-3,000 microns) and resolved with antimicrobial therapy.
- 86% of patients received inhaled pentamidine prophylaxis for PCP.
- Ocular findings showed minimal retinal destruction, with survival ranging from 2 to 36 weeks.
Conclusions:
- Pneumocystis choroidopathy serves as an accessible indicator of disseminated Pneumocystis infection in AIDS patients.
- Ocular examination can help evaluate the efficacy of Pneumocystis prophylaxis against extrapulmonary disease.