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Choroidal lesions in patients with AIDS.
M A Rosenblatt1, C Cunningham, S Teich
1Department of Ophthalmology, Mt Sinai School of Medicine, New York, NY.
The British Journal of Ophthalmology
|October 1, 1990
Summary
Seven AIDS patients developed bilateral choroidal lesions. Six cases were linked to aerosolized pentamidine for Pneumocystis pneumonia, often with concurrent mycobacterial infection, suggesting a distinct clinical entity in immunocompromised individuals.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Acquired Immunodeficiency Syndrome (AIDS) can manifest with opportunistic infections affecting various organs, including the choroid.
- Ocular manifestations in AIDS patients require careful differential diagnosis to guide appropriate management.
Observation:
- Seven cases of bilateral, scattered, yellow-white choroidal lesions were observed in patients with AIDS since January 1988.
- One case involved presumed cryptococcal meningitis extension into the optic nerve and choroid.
- Six patients presented with Pneumocystis pneumonia treated with aerosolized pentamidine, and five also had mycobacterial infections.
Findings:
- The six patients receiving aerosolized pentamidine for Pneumocystis pneumonia did not experience rapid disseminated infection, contrasting with prior reports.
- The presence of bilateral choroidal lesions in this cohort suggests a potential association with specific therapies or co-infections in AIDS patients.
- Mycobacterial infection was a common comorbidity in patients with these ocular findings.
Implications:
- These findings highlight a specific pattern of choroidal lesions in AIDS patients, potentially linked to Pneumocystis pneumonia treatment and mycobacterial co-infection.
- Understanding this entity is crucial for the differential diagnosis of visual disturbances and choroidal abnormalities in the immunocompromised population.
- Further research is warranted to elucidate the exact pathogenesis and clinical significance of these lesions in AIDS patients.