n Southern African Journal of HIV Medicine - Successful treatment of bilateral visual loss caused by idiopathic optic neuritis in an HIV-infected patient : case report
|Article Title||Successful treatment of bilateral visual loss caused by idiopathic optic neuritis in an HIV-infected patient : case report|
|Journal||Southern African Journal of HIV Medicine|
|Affiliations||1 University of Limpopo, 2 University of Limpopo, 3 University of Limpopo, 4 University of the Witwatersrand and 5 Wits Donald Gordon Medical Centre|
|Publication Date||Dec 2011|
|Pages||29 - 32|
Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types), auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzymelinked immunosorbent assay. The CD4 count was 85 cells/μl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.
Article metrics loading...