Which of the following is not true about ocular manifestation of HIV?
Ophthalmologic problems occur in ~50% of patients with advanced HIV infection. These are:- Funduscopy- cotton-wool spots-represent areas of retinal ischemia secondary to microvascular disease and are axoplasmic debris of dead neurons and don't harbour CMV, no visual loss--> patient stable/ improve with time CMV retinitis (CD4+ T cell count <100/ mL but majority occur at CD4+ T cell count <50/mL )- C/F : blurred vision, "floaters," and scintillations. - The disease is usually bilateral, although typically it affects one eye more than the other. The characteristic retinal appearance is that of perivascular hemorrhage and exudate--> visual loss is irreversible P. jirovecii can cause a lesion of the choroid that may be detected as an incidental finding on ophthalmologic examination. - These lesions are typically bilateral, are from half to twice the disc diameter in size, and appear as slightly elevated yellow-white plaques. They are usually asymptomatic and may be confused with cotton-wool spots. Chorioretinitis due to toxoplasmosis can be seen alone or, more commonly, in association with CNS toxoplasmosis. Kaposi sarcoma may involve the eyelid or conjunctiva, while lymphoma may involve the retina. Syphilis may lead to a uveitis that is highly associated with the presence of neurosyphilis.
50% of patients have cotton wool spots
Kaposi's sarcoma can be present on the eyelids
75% show vascular narrowing
Cotton wool spot harbors CMV
Investigation in ophthalmology and miscellaneous topics