Case Report

Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis

Claire Cullen, Baile Matlala, Fatima Laher, Ané Pienaar
Southern African Journal of HIV Medicine | Vol 12, No 4 | a169 | DOI: https://doi.org/10.4102/sajhivmed.v12i4.169 | © 2011 Claire Cullen, Baile Matlala, Fatima Laher, Ané Pienaar | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2011 | Published: 01 December 2011

About the author(s)

Claire Cullen,, South Africa
Baile Matlala,, South Africa
Fatima Laher,, South Africa
Ané Pienaar,, South Africa

Abstract

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 enzyme-linked 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.

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Crossref Citations

1. Bilateral optic neuritis: A new twist on immune reconstitution inflammatory syndrome
Ilya M. Sluch, Jeffrey LaCroix, Anil D Patel
Canadian Journal of Ophthalmology  vol: 52  issue: 3  first page: e104  year: 2017  
doi: 10.1016/j.jcjo.2016.09.015