Central retinal vein occlusion in a patient with HIV-associated thrombocytopenia



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Abstract

This article describes the case of a rare HIV complication of the central retinal vein occlusion (RVO), which occurred on the background of HIV-associated thrombocytopenia. Therapy of post-RVO macular edema in this case included intravitreal injections of Ozurdex combined with general antiretroviral drugs and systemic corticosteroid use. Significant visual function improvement and stabilization of the process were achieved in 15 months in spite of the delayed treatment start (three months after the disease onset) and patient’s resistance to previous therapy. Three intravitreal injections of Ozurdex were performed, intervals between injections being from 5 to 6 months.

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About the authors

Svetlana Nikolaevna Tultseva

First Pavlov State Medical University of St. Petersburg

Email: tultceva@yandex.ru
MD, PhD, Doc. Med. Sci., assistant professor. Ophthalmology Department

Yury Sergeevich Astakhov

First Pavlov State Medical University of St. Petersburg

Email: astakhov73@mail.ru
MD, PhD, Doc. Med. Sci., professor. Ophthalmology Department

Pavel Andreevich Nechiporenko

First Pavlov State Medical University of St. Petersburg

Email: glaz@doctor.com
MD, PhD, assistant professor. Ophthalmology Department

Aleksandra Ivanovna Titarenko

First Pavlov State Medical University of St. Petersburg

Email: aleksandra-titarenko@yandex.ru
resident. Ophthalmology Department

References

  1. Астахов Ю. С., Даль Н. Ю., Лисочкина А. Б., Тульцева С. Н., Шадричев Ф. Е. Глава 6. Заболевание сетчатки. В кн.: Руководство по клинической офтальмологии. Под ред. Ю. С. Астахов, А. Ф. Бровкина. М.: Медицинское информационное агенство. 2014; 297-374.
  2. Всемирная организация здравоохранения (официальный сайт). URL: http://www.who.int/ru.
  3. Независимое издание для практикующих врачей Ермакова Н. А. СПИД. Офтальмологические проявления. Литературный обзор (официальный сайт). URL: www.rmj.ru.
  4. Лечение ВИЧ-инфекции 2011 (официальная сайт). URL: www.hivbook.com.
  5. Тульцева С. Н., Нечипоренко П. А., Титаренко А. И. Использование интравитреального имплантата «Озурдекс» в терапии постокклюзионного макулярного отека. Офтальмологические ведомости. 2014; 7 (3): 5-16.
  6. Тульцева С. Н., Атсахов Ю. С. Роль воспаления в патогенезе посттромботического макулярного отека. Современные направления медикаментозного лечения. Офтальмологические ведомости. 2012; 5 (4): 35-44.
  7. Тульцева С. Н. Эндотелиальные регуляторы фибринолиза у больных с тромбозом вен сетчатки. Офтальмологические ведомости. 2009; 2 (1): 4-11.
  8. Хижняк Т. В., Астахов Ю. С., Рахманова А. Г. Структура заболеваний глаза в зависимости от стадии ВИЧ-инфекции. Офтальмологические ведомости. 2009; 3 (1): 15-9.
  9. Хижняк Т. В., Астахов Ю. С. К вопросу о ранней диагностики ЦМВ-ретинита у больных с ВИЧ-инфекцией. Офтальмологические ведомости. 2011; 4 (2): 39-44.
  10. Abdollahi A., Shoar T. S. Hyperhomocysteinemiain HIV-InfectedIndividuals: Correlation of a Frequent Prothrombotic Factor with CD4+ Cell Count. Oman Medical J. 2012; 27 (3): 224-7.
  11. Afessa B., Green W., Chiao J., Frederick W. Pulmonary compications of HIV infection: autopsy findings. Chest. 1998; 113 (5): 1225-9.
  12. Bertram B., Remky A., Arend O., Wolf S., Reim M. Protein C, protein S, and antithrombin III in acute ocular occlusive diseases. Ger J Ophthalmol. 1995; 4 (6): 332-5.
  13. Crum-Cianflone N. F., Weekes J., Bavaro M. Thromboses among HIV-Infected Patients during the HAART Era. AIDS Patient Care STDS. 2008; 22 (10): 771-8.
  14. Dunn J. P., Yamashita A., Kempen J. H., Jabs D. A. Retinal vascular occlusion in patients infected with human immunodeficiency virus. Retina. 2005; 25 (6): 759-66.
  15. Erdol H., Turk A., Caylan R. An unusual cause of central retinal artery occlusion: Acquired immunodeficiency syndrome. European Journal of Ophthalmology. 2007; 17 (4): 671-3.
  16. Faber. W., Wiley C. A., Lynn G. B., Gross J. G., Freeman W. R. Role of HIV and CMV in the Pathogenesis of Retinitis and Retinal Vasculopathy in AIDS Patients. Investigative Ophthalmology & Visual Science. 1992; 33 (8): 2345-53.
  17. Feffer S. E., Fox R. L., Orsen M. M., Harjai K. J., Glatt A. E. Thrombotic tendencies and correlation with clinical status in patients infected with HIV. South Med J. 1995; 88 (11): 1126-30.
  18. Gharai S., Venkates P., Tandon R., Garg S. Peripheral ulcerative keratitis and central retinal vein occlusion as the initial manifestation of HIV infection. Optom Vis Sci. 1992; 69 (7): 567-9.
  19. Glacet-Bernard A., Bayani N., Chretien P., Cochard C., Lelong F., Coscas G. Antiphospholipid antibodies in retinal vascular occlusions. A prospective study of 75 patients Ger J Ophthal. 1995; 4 (6): 332-5.
  20. HassellK. L., Kressin D. C., Neumann A., Ellison R., Marlar R. A. Correlation of antiphospholipid antibodies and protein S deficiency with thrombosis in HIV-infected men. Blood Coagul Fibrinolysis. 1994; 5 (4): 455-62.
  21. HIV InSite Knowledge Base ChapterAhmed I., Ai E., Chang E., Luckie A. Ophthalmic Manifestations of [official site]. http://hivinsite.ucsf.edu/InSite?page=kb-04-01-12.
  22. Ismail Y., Nemechek P., Arsura E. A rare cause of visual loss in AIDS patients: central retinal vein occlusion. British Journal of Ophthalmology. 1993; 77: 600-1.
  23. Lijfering W. M., Ten Kate M. K., Sprenger H. G., van der Meer J. Absolute risk of venous and arterial thrombosis in HIV-infected patients and effect of combination antiretroviral therapy//J Thromb Haemost. 2006; 4 (9): 1928-30.
  24. Littleton N. Thrombocytopenia in HIV. CME. 2007; 25 (6): 272-5.
  25. MansourA. M., Li H., Segal E. I. Picture resembling hemicentral retinal vein occlusion in the acquired immunodeficiency syndrome//Ophthalmologica. Journal International D’ophtalmologie. International Journal of Ophthalmology. Zeitschrift fur Augenheilkunde. 1996; 210 (2): 108-11.
  26. Miguez-Burbano MJ, Jackson J Jr, Hadrigan S. Thrombocytopenia in HIV disease: clinical relevance, physiopathology and management. Curr Med Chem Cardiovasc Hematol Agents. 2005; 3 (4): 365-76.
  27. Northfelt D. W. Hematologic Manifestations of HIV//J Acquire Immune Defic Syndr Hum Retrovirol. 1995; 8 (1): 45.
  28. Palmowski-Wolfe A. M., Denninger E., Geisel J., Pindur G., Ruprecht K. W. Antiphospholipid antibodies in ocular arterial and venous occlusive disease. Ger Journal Ophthalmol. 1995; 4 (6): 332-5.
  29. Park K. L., Marx J. L., Lopez P. F., Rao N. A. Noninfectious branch retinal vein occlusion in HIV-positive patients. Internaional Ophthalmology. 1995/96; 19 (4): 249-52.
  30. Roberts S. P., Haefs T. M. Central vein occlusion in a middle-aged adult with HIV infection. Optometry and Vision Science: Official Publication of the American Academy of Optometry. 1992; 69 (7): 567-9.
  31. Saber A. A., Aboolian A., LaRaja R. D., Baron H., Hanna K. HIV/AIDS and the risk of deep vein thrombosis: a study of 45 patients with lower extremity involvement. Am Surg. 2001; 67 (7): 645-57.
  32. Said M. W., Bona R., Greenberg B. AIDS and Thrombosis: Retrospective Study of 131 HIV-Infected Patients. AIDS Patient Care and STDs. 2001; 15 (6): 311-20.
  33. SaidM. W., Greenberg B. HIV and Thrombosis: A Review. AIDS Patient Care and STD. 2001; 15 (1): 15-24.
  34. Stewart M. W. Human immunodeficiency virus and its effects on the visual system. Infectious Disease Reports. 2012; 4 (25): 92-100.
  35. Takeli O., Gurcel E., Buyurgan H. Protein C, protein S, and antithrombin III deficiencies in retinal vein occlusion. Acta Ophthalmol Scand. 1999; 77 (6): 628-30.
  36. Teich S. A., Sonnabend J. Central Retinal Vein Occlusion in a Patient With AIDS. Arch Ophthalmol. 1988; 106 (11): 1508-9.
  37. Trotti R., Rondanelli M., Anesi A., Gabanti E., Brustia R., Minoli L. Increased erythrocyte glutathione peroxidase activity and serum tumor necrosis fastor-alpha in HIV-infected patients: relationship to on-going prothrombotic state. J Hematother Stem Cell Res. 2002; 11 (2): 369-75.
  38. Vannappagari V., Nikhoma E. T., Atashili J., Laurent S. S., Zhao H. Prevalence, severity, and duration of thrombocytopenia among HIV patients in the era of highly active antiretroviral therapy. Platelets. 2001; 22 (8): 611-18.
  39. Vrabek T. R. Posterior segment manifestations of HIV/AIDS. Surv Ophtalmol. 2004; 49: 131-57.
  40. Wen F., Chen X., Li H., Liao R., Wu D. Bilateral central retinal vein occlusions combined with artery occlusions in a patient with acquired immune deficiency syndrome. Yan ke xue bao = Eye Science. 2002; 18 (1): 27-9.
  41. Wen F., Chen X., Liao R. Bilateral central retinal vein occlusions in a Chinese patient with HIV-infection. Yan ke xue bao = Eye Science. 2002; 18 (1): 27-9.

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Copyright (c) 2015 Tultseva S.N., Astakhov Y.S., Nechiporenko P.A., Titarenko A.I.

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