ABSTRACT
We present a case of late acute myopia syndrome following discontinuation of treatment with a combination of sulphonamide drugs. To the best of our knowledge, this is the first reported case with such a presentation, and suggests that the pathophysiological basis for the acute myopia syndrome is a rapid decrease in serum carbonic anhydrase inhibitors levels which may lead to a rebound increase in the production of aqueous humor and accumulation of suprachoroidal fluid. It is further postulated that there may be a cumulative effect of sulphonamide drug use on carbonic anhydrase activity in the ciliary body epithelium of susceptible individuals.
Subject(s)
Anti-Infective Agents/adverse effects , Anticonvulsants/adverse effects , Fructose/analogs & derivatives , Myopia/chemically induced , Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects , Acute Disease , Adult , Drug Therapy, Combination , Female , Fructose/adverse effects , Humans , Intraocular Pressure/drug effects , Migraine Disorders/prevention & control , Myopia/diagnosis , Pharyngitis/drug therapy , TopiramateABSTRACT
CMV retinitis is the most serious ocular complication of AIDS. Introduction of the combination antiretroviral therapy markedly reduced the occurrence of CMV retinitis, on the other hand it brought a new ocular complication - CMV uveitis. CMV uveitis is an immunopathological inflammatory reaction associated with the immune reconstitution inflammatory syndrome, which is a side effect of successfully initiated cART. These two forms of CMV ocular complications differ in pathogenesis, symptomatology and therapy. The CMV retinitis is treated with anti-CMV virostatics whereas the therapy of CMV uveitis is based on attenuation of the inflammatory reaction by administration of corticosteroids. The optimal prevention of both complications is an early initiation of cART before the CD4+ T lymphocytes drop below 200/microl.
Subject(s)
AIDS-Related Opportunistic Infections , Cytomegalovirus Infections/complications , Cytomegalovirus Retinitis/complications , HIV Infections/complications , Uveitis/complications , HIV Infections/drug therapy , Humans , Immune Reconstitution Inflammatory Syndrome/complications , Uveitis/virologyABSTRACT
HIV retinopathy is an ocular affection occurring especially in HIV positive patients with deep immunodeficiency. Because of benign character the HIV retinopathy does not require any specific therapy, but it must be carefully distinguished from other ocular diseases, which can seriously damage sight, e.g. CMV retinitis. The presence of HIV retinopathy can also be a symptom of progression of HIV infection and should be perceived as a signal for considering the initiation of antiretroviral therapy in treatment naive patients.
