Ananth J Vijay, Sudharshan S, Selvakumar Ambika, Devaleenal Bella J, Kalaivani Kavitha, Biswas Jyotirmay
Department of Neuroophthalmlogy, Anand Eye Hospital, Madurai, Tamil Nadu, India.
Uvea Department Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2018 Jan;66(1):168-169. doi: 10.4103/ijo.IJO_592_17.
Papilledema in a patient with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome is an alarming finding. Any condition giving rise to raised intracranial tension (ICT) can cause papilledema, and in these patients, it could be secondary to opportunistic infections like meningitis to neoplasm. We report a case of a 28-year old female with HIV on antiretroviral therapy, who presented to us, with papilledema. Her fundus examination revealed superficial hemorrhages and Roth's spots along with papilledema. Patient was diagnosed with idiopathic intracranial hypertension (IIH), and all other possible systemic associations were ruled out. Her blood tests showed severe anemia. The papilledema and retinal changes resolved with treatment of anemia. This is a rare presentation of IIH in HIV positive patient due to anemia, secondary to zidovudine adverse effect.
人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征患者出现视乳头水肿是一个令人担忧的发现。任何导致颅内压升高(ICT)的情况都可能引起视乳头水肿,在这些患者中,可能继发于机会性感染,如脑膜炎至肿瘤。我们报告一例28岁接受抗逆转录病毒治疗的HIV女性患者,她因视乳头水肿前来就诊。她的眼底检查发现有浅表出血和 Roth 斑以及视乳头水肿。患者被诊断为特发性颅内高压(IIH),并排除了所有其他可能的全身相关性。她的血液检查显示严重贫血。贫血经治疗后,视乳头水肿和视网膜病变得以缓解。这是由于齐多夫定不良反应继发贫血导致的HIV阳性患者中IIH的罕见表现。