Augnsjúkdómar í alnæmi

Abstract

Ocular complications of acquired immunodeficiency syndrome are common and often very serious. We studied the incidence of ocular complications of AIDS in Iceland, patients visual handicap and survival after developement of ocular complications. We made a retrospective study of hospital files and fundus photographs of AIDS patients who were examined at the Department of Ophthalmology St. Joseph's Hospital prior to September 30th 1993. As of September 30th 1993, 81 Icelanders were known to be HIV-infected and 29 of those had developed AIDS. Twelve HIV-positive patients were examined at the Department of Ophthalmology, nine of whom had ocular complications (8 of 9 had AIDS). Four had died by September 30th 1993 (all with cytomegalovirus retinitis). Six patients had cytomegalovirus retinitis, one had optic nerve atrophy, one had chronic herpes simplex keratitis and six had retinal microvasculopathy (in one case the only ocular complication). Survival after diagnosis of cytomegalovirus retinitis was 2, 10, 12.5 and 14 months. Two patients became blind (<3/60 on better eye). Two patients developed retinal detachments which was repaired in one of them. Ocular complications of AIDS can cause a serious handicap in otherwise relatively healthy AIDS patients. As immunodeficient patients will survive longer with better treatment against the HIV-infection, ocular complications will make increased demand on ophthalmological and other medical services.

Tilgangur þessarar rannsóknar var að kanna algengi augnfylgikvilla alnæmis á Íslandi, lífshorfur sjúklinga eftir að þeir hafa fengið augnsjúkdóma og fötlun þeirra. Tólf HIV (Human Immunodeficiency Virus) -jákvæðir sjúklingar komu til skoðunar á augndeild Landakotsspítala fram til 30. September 1993. Níu þeirra höfðu augnfylgikvilla (átta af þeim með alnæmi). Fjórir höfðu látist 30. September 1993. Sex sjúklingar voru með cýtómegalóveiru (CMV) sjónubólgu, einn með sjóntaugarrýrnun, einn með langvinna herpes simplex glærubólgu og sex með æðasjúkdóma í augnbotni. Lífshorfur eftir að CMV sjónusýking greindist voru tveir, 10, 12,5 og 14 mánuðir. Tveir sjúklingar urðu blindir (innan við 3/60 á betra auga). Tveir fengu sjónulos og annar þeirra fór í skurðaðgerð þess vegna. Augnfylgikvillar alnæmis valda alvarlegri fötlun. Horfur eru á að þeir verði vaxandi vandamál eftir því sem alnæmissjíiklingum fjölgar og þeir lifa lengur með betri meðferð.