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Multimodal Imaging in AIDS-Related Ocular Cryptococcosis
Maria Fernanda Flores Herrera1, Nicolas Dauby2, Evelyne Maillart3
1Department of Ophthalmology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Case Reports in Ophthalmological Medicine
|February 25, 2021
Summary
Multimodal imaging revealed AIDS-related cryptococcal chorioretinitis involving uveitis and vasculitis. This approach is crucial for evaluating and monitoring ocular infections caused by Cryptococcus neoformans in HIV patients.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Imaging
Background:
- AIDS-related opportunistic infections can cause severe ocular manifestations.
- Cryptococcus neoformans meningitis is a serious complication in advanced HIV.
- Ocular involvement in cryptococcal meningitis requires prompt diagnosis and management.
Observation:
- Two cases of AIDS-related cryptococcal chorioretinitis with uveitis and vasculitis are presented.
- Patients had untreated HIV infection with low CD4+ T cell counts.
- Ocular symptoms appeared during antifungal therapy for cryptococcal meningitis.
Findings:
- Fundus examination showed vitritis in both cases.
- Fluorescein angiography (FA) identified vasculitis.
- Indocyanine green angiography (ICG) revealed choroidal involvement.
- Optical coherence tomography (OCT) aided in assessing treatment response alongside FA and ICG.
Implications:
- Cryptococcus neoformans can affect nearly all ocular structures.
- Multimodal imaging is essential for baseline evaluation of ocular infections.
- Imaging plays a critical role in monitoring treatment response in these patients.
