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Ocular manifestations in pediatric patients with acquired immunodeficiency syndrome
P J Dennehy1, R Warman, J T Flynn
1Department of Ophthalmology, Bascom Palmer Eye Institute, Detroit, Mich.
Insights
Ocular findings in pediatric acquired immunodeficiency syndrome (AIDS) are less common than in adults. Regular ophthalmic screening is recommended for children with AIDS, especially those with neurological issues or opportunistic infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Pediatric acquired immunodeficiency syndrome (AIDS) can present with various clinical manifestations.
- Ocular involvement in human immunodeficiency virus (HIV)-infected children requires prospective evaluation.
- Understanding the incidence and natural history of eye conditions in pediatric AIDS is crucial for patient management.
Purpose of the Study:
- To prospectively evaluate the incidence, type, and natural history of ocular involvement in pediatric patients with acquired immunodeficiency syndrome (AIDS).
Main Methods:
- Ophthalmic examinations were conducted on 40 pediatric patients seropositive for HIV antibody and meeting the CDC case definition for AIDS.
- A total of 87 examinations were performed throughout the study period.
Main Results:
- Twenty percent of pediatric AIDS patients exhibited ocular findings.
- Identified ocular conditions included cytomegalovirus retinitis, retinal cotton-wool spots, toxoplasmosis retinochoroiditis, and external adnexal infections.
- One patient presented with unusual peripheral retinal findings.
Conclusions:
- Ocular manifestations are less frequent in pediatric AIDS compared to adult series.
- Ophthalmic screening is recommended for pediatric AIDS patients with encephalopathy, disseminated opportunistic infections, or suggestive symptoms.
Abstract:
Forty pediatric patients seropositive for human immunodeficiency virus antibody and conforming to Centers for Disease Control, Atlanta, Ga, case definition of acquired immunodeficiency syndrome underwent ophthalmic examinations to evaluate prospectively the incidence, type, and natural history of ocular involvement in pediatric acquired immunodeficiency syndrome. A total of 87 examinations were performed on the patient population throughout the course of the study. Twenty percent had ocular findings, including two cases of cytomegalovirus retinitis, one case of isolated retinal cotton-wool spots, one case of toxoplasmosis retinochoroiditis, and three cases of external infections of adnexal structures. One patient had unusual peripheral retinal findings. The incidence of ocular manifestations in pediatric acquired immunodeficiency syndrome is considerably less than reported in several adult series. However, we recommend ophthalmic screening in all pediatric patients with acquired immunodeficiency syndrome with encephalopathy or disseminated opportunistic infections, or when symptoms suggest ophthalmic involvement.