New Insights into Ocular Complications of Human Immunodeficiency Virus Infection

Abstract

HIV/AIDS continues to be a major global public health issue, affecting multiple organs, such as the eyes. With the advent of Highly Active Antiretroviral Therapy (HAART), the incidence has dropped but HIV ocular complications still remain a major cause of vision impairment in HIVpositive individuals. Since modern medical interventions nowadays can change this previously fatal infection into a chronic disease and enable people living with HIV for relatively long and healthy lives, recent studies update the incidence of HIV-related ocular manifestations, which has reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and the clinical ocular findings are similar, which may be a problem to diagnose in the setting of disease. In our discussion, these complications are classified by etiology, for example noninfectious microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections caused by a virus, such as cytomegalovirus and varicella-zoster virus, fungus for example, candida and cryptococcus, bacteria like mycobacterium, parasites, such as toxoplasma and pneumocystis, and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility of virus reservoir in the eyes, which makes HIV-related oculopathy still ubiquitous even after successful systemic treatment.