Case Report

Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis

Claire Cullen, Baile Matlala, Fatima Laher, Ané Pienaar
Southern African Journal of HIV Medicine | Vol 12, No 4 | a169 | DOI: | © 2011 Claire Cullen, Baile Matlala, Fatima Laher, Ané Pienaar | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2011 | Published: 01 December 2011

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Claire Cullen,, South Africa
Baile Matlala,, South Africa
Fatima Laher,, South Africa
Ané Pienaar,, South Africa

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Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types), auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzyme-linked immunosorbent assay. The CD4 count was 85 cells/µl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.


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Crossref Citations

1. Bilateral optic neuritis: A new twist on immune reconstitution inflammatory syndrome
Ilya M. Sluch, Jeffrey LaCroix, Anil D Patel
Canadian Journal of Ophthalmology  vol: 52  issue: 3  first page: e104  year: 2017  
doi: 10.1016/j.jcjo.2016.09.015