Ocular manifestation and their associated factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Southern Ethiopia

AIM：To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus（HIV）/acquired immunodeficiency syndrome（AIDS） patients on highly active antiretroviral therapy（HAART） at Hawassa University Referral Hospital, Southern Ethiopia. METHODS：A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS：The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis（5%） was the most common ocular manifestation, followed by squamoid conjunctival growth（3.8%）. The rate of ocular manifestation was significantly higher among study participants who had CD4＋ count 〈200 cells/μL（AOR=3.83; 95%CI：1.315-11.153）, low duration of HAART（AOR=3.0; 95%CI：1.305-6.891） and who had primary school education [odds ratio（OR） =2.8; 95%CI：1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively.CONCLUSION：HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of 〈200/μL cells and in the first five years of HAART followup is recommended to reduce visual impairment and/or blindness.

Ocular Manifestations in Thyroid Eye Disorder: A Cross-Sectional Study from Nepal

Background: Thyroid eye disease represents an organ-specific autoimmune process that is usually associated with thyroid disease. Graves’ disease is the most common thyroid abnormality associated with thyroid eye disease. Aim: This study was conducted for the profile of ocular manifestation in Thyroid Eye Disease (TED). Methodology: A cross-sectional study of 117 cases of thyroid dysfunction was carried out at BP Koirala Institute of Health System, out of which 84 (71.79%) cases had ocular manifestation. They were evaluated and analyzed in detail and the characteristics documented included patient’s demography, ocular and systemic history and as well as ocular examination and some of the systemic and laboratory findings. Results: In this study, mean age of presentation of TED was 39.7 years. 59 patients were female and 25 were male. The maximum patients of both sexes were in the fourth decade of their lives. The common lid signs were lid retraction and lid lag. Proptosis was seen in 33.3% of cases out of which 68% had bilateral proptosis. Corneal ulcer was seen in 7.1% and optic neuropathy in 1.2% of cases. In 27.3% of cases there was elevation of IOP. Dry eye was seen in 61.9% of cases and POAG seen in 8.3% of cases. In the study population 75% were hyperthyroiditic, 16.7% were hypothyroiditic and 8.3% were in euthyroid state. Conclusion: Female was more commonly affected. The maximum number of patients of both sexes was in the fourth decade of their lives. Hyperthyroidism patient had greater chance of ocular manifestation.

Ocular Manifestations in Granulomatosis with Polyangiitis Patients from Saudi Arabia

Eye and/or orbit involvement occurs in Granulomatosis with polyangiitis (GPA) patients frequently. The aim of our study was to describe the clinical manifestations, therapy and outcome of ocular involvement in our GPA patients. A retrospective study was conducted including patients with GPA who followed up in Rheumatology clinics during 1990-2016 at King Khalid University Hospital, Riyadh. Information relating to demographics, ocular manifestations, laboratory findings, therapy and outcome of GPA patients were noted. Ocular involvement was detected in 9 (39.1%) of the 23 GPA cases identified. The mean age of ocular GPA patients was 51.8 (range 27 - 62) years, the mean age at onset of disease was 39.6 (range 11 - 57) years and the mean duration of disease was 9.0 (range 2 - 19) years. Concomitant ear, nose, throat and sino-nasal manifestations occurred with ocular symptoms in 77.8% GPA patients. The most frequent manifestations were, eye pain (66.7%), scleritis/episcleritis (55.6%), eye redness and itching (55.6% each). Antineutrophil cytoplasmic antibodies (ANCA) were positive in 88.9% patients, 55.6% had c-ANCA and 33.3% had p-ANCA. Infections were observed in 22.2% of patients, which included pneumonia in one patient and esophageal candidiasis and bacterial meningitis in another. All patients received oral prednisolone, 44.4% received intravenous cyclophosphamide, 22.2% refractory cases received rituximab doses and the disease outcome was good. Comparison of ocular GPA with non-ocular GPA patients showed that 77.8% of ocular GPA patients had concomitant sino-nasal symptoms compared to 42.9% in non-ocular GPA patients and 22.2% of the ocular GPA patients had renal involvement compared to 64.3% in non-ocular GPA patients (p = 0.049). We found that the frequency of ocular manifestations in our GPA patients was similar to reports elsewhere, and the most frequent symptom was eye pain and scleritis/episcleritis.

Ocular Manifestations in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of this autoimmune disease vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Their appearance, as well as their severity are related to RA chronicity and resistance to therapy. The treatment consists of corticosteroids, NSAIDs and cytotoxic drugs, depending on the type of ocular manifestations and the patient’s response to treatment.

Ocular Manifestations among HIV Infected Children in Ouagadougou, Burkina Faso

Ocular manifestations among HIV infected children are diverse and global incidence varies from 7% to 75%. At this age, eye lesions are often unnoticed because of the incapacity to express eye discomfort. The purpose of this study is to describe ocular manifestations among HIV-infected children and hence associated factors in the Department of Paediatrics at the Yalgado Ouédraogo Teaching Hospital. This was a cross-sectional descriptive and analytical study conducted between July 2014 and December 2014. A complete ophthalmic examination was systematically done to all HIV-positive children attending the clinic, as part of their routine medical visit. The most recent socio-demographic, clinical, biological and treatment data were registered. Seventy-nine children had an ocular examination and among them 92.4% were on ARV treatment. The incidence of ocular manifestations was 46.7%. Median age was 8 years old (interquartile 6 - 12 years old). Sex ratio was 1.3. The risk of ocular manifestations involvement among boys was twice than that of girls. More than half (59.5%) of children who had ocular problems had not expressed ocular discomfort. Ocular adnexal lesions were more common (35.4%) compared to eye segments (8.9%) lesions. Anterior segment and posterior segment lesions were statistically associated with immune system depression (p = 0.003 and 0.001). However, this relationship was not statistically significant (p = 0.15). Five out of seven children who had eye fundus lesions had CD4 count 3. Ocular manifestations were very common among HIV infected children in our context. Ophthalmic examination should be systematic at admission and regularly repeated during follow-up.

COVID-19 and ocular complications:A review of ocular manifestations,diagnostic tools,and prevention strategies

Background:The novel severe acute respiratory syndrome coronavins 2(SARS-CoV-2)led to the severe Corona Virus Disease 2019(COVID-19)outbreak that started in December 2019 in China and caused enormous health and economic problems worldwide.Over time,SARS-CoV-2 has demonstrated the capacity for mutation.As the most prevalent new coronavirus variety worldwide,the Omicron variant has supplanted the Delta variant.The COVID-19 primarily damages the immune system and the lungs,but it can also harm other organs secondarily,depending on the patients'co-existing conditions.Main Text:COVID-19 is associated with ophthalmic manifestations such as conjunctival congestion,tear overflow,and conjunctival edema,with the majority of eye complications occurring in patients with severe infection.The virus may make a patient more susceptible to thrombotic conditions that affect venous and arterial circulation.Meanwhile,it can lead to efferent complications and mucormycosis which is more common in patients with diabetes or who have critical or severe SARS-CoV-2 infection.Significantly,there are a number of ocular side effects following the COVID-19 vaccination,such as herpetic keratitis and facial nerve palsy,which have been reported.These side effects may be caused by the vaccinations'propensity to trigger autoimmune symptoms or thromboembolic events.At present,large-scale nucleic acid testing mainly relies on nasopharyngeal swabs and throat swabs.Tear samples and conjunctival swabs may be helpful samples for the diagnosis of ocular SARS-CoV-2 infection.The eye could be a new route of infection,and finding ways such as effective environmental disinfection,scientific administrative control management,qualified personal protection and other measures to protect the eyes could further reduce the risk of infection.Conclusions:This review aims to sum up the ocular complications of COVID-19,the possible pathogenesis,and preventive strategies to protect ophthalmology practitioners and patients by reviewing the currently available literature on the topic.

Ocular manifestations of intracranial germinomas： three cases report and literature review

Intracranial germinomas are malignant neoplasms of gonadal origin, which have some features in terms of age, sex, and clinical manifestations. They mainly occur in children and adolescents. Patients with intracranial germinomas mainly manifest with hypothalamic pituitary axis dysfunction and/or compression syndromes. Visual disturbance is one of the most Significant clinical presentations, which is mainly caused by tumor cell infiltration into the optic pathway. In this article, we present three cases of patient with intracranial germinoma to analyze the ocular manifestations. All the three patients presented with endocrine symptoms in the early stage and with visual disturbances （including decreased visual acuity and visual field defects） later. In general, germinoma is diagnosed by its characteristic radiological appearance, supported by tumor markers and/or stereotactic biopsy. However, decisive diagnoses were established when ocular manifestations were presented. A suspicion for germinoma should be considered, when young patients manifest visual disturbances accompanied by endocrine symptoms.

Clinical manifestations and outcomes of ocular sarcoidosis in Saudi Arabia

Dear Sir,We write to report on the clinical manifestations and outcomes of ocular sarcoidosis in patients presenting to uveitis referral centers in the Kingdom of Saudi Arabia.This is the first report focused solely on ocular sarcoidosis from this country.