Abstract :
Purpoe
To decribe change in the acquired immunodeficiency yndrome (AID) epidemic that are important to ophthalmologit, to provide an overview of iue relevant to current evaluation and treatment of human immunodeficiency viru (HIV)-related eye dieae, and to identify problem related to the eye and viion that require continued tudy.
Deign
Literature review and commentary.
Method
elected article from the medical literature and the author’ clinical and reearch experience over 25 year were reviewed critically.
Reult
The AID epidemic ha had a profound impact on ophthalmology ince the ophthalmic manifetation of AID were firt decribed in 1982. The introduction of highly active antiretroviral therapy (HAART) ha markedly reduced the incidence of cytomegaloviru (CMV) retiniti, but ha not eliminated new cae altogether. Treatment trategie for CMV retiniti have evolved over the pat decade. Current iue of importance include choice of initial anti-CMV drug; time at which anti-CMV drug treatment i dicontinued in patient who achieve immune recovery; trategie for monitoring patient at rik for dieae reactivation; and management of complication (retinal detachment, immune recovery uveiti). Attention alo i being directed to the problem of viual diturbance (reduced contrat enitivity, altered color viion, viual field abnormalitie) that can occur in HIV-infected individual without infectiou retinopathie.
Concluion
Ocular diorder aociated with HIV dieae remain important problem in the United tate, depite HAART, and increaingly are important worldwide. The approach to management of CMV retiniti ha evolved from hort-term treatment of a preterminal infection to the long-term management of what ha become a chronic dieae. Many challenge remain to be addreed.
