J Med Assoc Thai 2003; 86 (5):399

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Epidemiology of the Ocular Complications of HIV Infection in Chiang Mai
Ausayakhun S Mail, Watananikom S , lttipunkul N , Chaidaroon W , Patikulsila P , Patikulsila D

Objective : To identify the magnitude of ocular complications in HIV infection in Chiang
Mai, and determine the signs or symptoms that indicate the risk factors for developing ocular compli-
cations in HIV -positive patients
Method : A prospective study was carried out in newly diagnosed HIV-positive patients seen
in the Ocular Infectious Disease Clinic of Maharaj Nakom Chiang Mai Hospital from March I, 2000
through February 28, 200 I. A complete ophthalmic examination was performed on each patient together
with a systemic evaluation of present illness and current medications.
Results : Three-hundred and ninety-five HIV -positive patients were seen for ophthalmic
evaluation. Of these, 90 were in stage A (asymptomatic), 84 were in stage B (symptomatic), and 221
were in stage C (AIDS). Ocular complications were found in 44.6 per cent of the patients. Cytomegalo-
virus (CMV) retinitis was the most common ophthalmic complication (33%). Other ocular complica-
tions included cotton wool spot (8% ), uveitis (4% ), optic neuropathy (3% ), and keratoconjunctivitis
sicca (2%). The clinical presenting symptoms, which were the indicators for ocular complications and
CMV retinitis, included chronic cough, oral thrush, chronic diarrhea, weight loss, wasting, and skin dis-
orders. Ocular symptoms, which indicated a high risk of developing CMY retinitis, included flashing,
floaters, and scotoma.
Conclusions : Ocular complications are common in HIV-positive patients. CMY retinitis.
which is a major vision-threatening problem, represented the most common finding. It is recommended
that HIV-positive patients should have their eyes examined regularly, particularly when they have the
clinical presenting symptoms previously mentioned. The patients should also notice early symptoms of
CMV retinitis, which includes flashing, floaters, and scotoma.
Key word : HIV, Eye Complications, CMV Retinitis

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