[Ocular lesions in AIDS: the first 12 Tunisian cases]

A retrospective study of 12 patients (10 men and 2 women) aged 10-40 presenting with AIDS at the infectious disease service of Rabta Hospital in Tunisia was conducted to determine the incidence of ocular lesions in AIDS patients and to stress the diagnostic prognostic and therapeutic importance of the ophthalmological examination of AIDS patients. Only 2 cases (17%) had a normal ophthalmological exam. The ocular lesion in 2 of the 10 remaining cases revealed AIDS. The most common ocular lesions were cotton wool spots (6 cases) and cytomegalovirus (CMV) retinitis (2 cases) both of which predicted a poor prognosis. Other ocular lesions included toxoplasmic retinochoroiditis periphlebitis and retinal hemorrhage. Risk factors included parenteral toxicomania (50%) heterosexual contact (67%) bisexual contact (17%) blood transfusion (34%) and multiple risk factors (58%). The most frequent non-ocular opportunistic infections were pulmonary pneumocystis (25%) cerebral toxoplasmosis (17%) and CMV infection (17%). One case had dermal gastric and bronchial Kaposis sarcoma. The researchers recommended that health providers follow every HIV positive patient and that infectious disease specialists and ophthalmologists collaborate in the care of HIV positive patients.