Ophthalmic manifestation of aids in Armed Forces General Teaching Hospital, Addis Ababa.

Background: The eye is one of the commonly affected organs by HIV/AIDS. However, data on HIV/AIDS related ophthalmic lesion is scarce in Ethiopia and in other sub-Saharan Africa countries, where two-third of the world-infected people are living.

Objective: To determine the proportion, describe the pattern, and assess the visual impairment of AIDS related ophthalmic lesions in comparison to CD+ T-lymphocyte count.

Methods: This is a cross-sectional descriptive study conducted on AIDS patients. Consecutive patients whose CD4+ T-lymphocyte count was 200 cell/microl and below, diagnosed to have AIDS and not started on Antiretroviral therapy (ART) were evaluated for ophthalmic lesions over a period of one year.

Results: A total of 186 (26 females and 160 males) with mean age 34.3 +/- 7.6 years were examined CD4+ T-lymphocyte was ranging from 1 to 200 cell/microl. Sixty-one (32.8%) patients were found to have HIV/AIDS related ophthalmic lesions. Four of them had more than one lesion. Among the lesions, microvasculopathy (64% of them having CD4 less than 50) was by far the commonest accounting for 25/65 (38.1%), followed by Molluscum contageosum of the eyelids 10/65 (15%). Herpes Zoster Opthalmicus (HZO), uveitis, CMV retinitis were next common 4/65 (6.2% each). Eleven unilaterally and two bilaterally were blind. The leading cause of blindness was cytomegalovirus retinitis followed by HZO, uveitis and presumed toxoplasmisis chorioretinitis. The likelihood of having HIV/AIDS related lesion was higher among cases with CD4+ T-lymphocyte count of 50 and below (Adjusted OR = 12.25; 95% CI; 1.09, 4.63).

Conclusion: The presence of visual threatening ophthalmic lesions in highly immunocompromised AIDS patient shows the importance of early detection and treatment. ART could have impact on the pattern of the ophthalmic lesions, hence further study is recommended.