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All Journal The Indonesian Biomedical Journal Jurnal SainHealth JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Journal of Stem Cell Research and Tissue Engineering CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology Vision Science and Eye Health Journal Ophthalmologica Indonesiana IPSSJ
Zuhria, Ismi
Department Of Ophthalmology, Faculty Of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Biochemistry, Genetics & Molecular Biology Chemistry Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health Social Sciences Veterinary

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UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS: Poster Presentation - Case Report - Resident Bening, Daya Banyu; Firmansjah, Muhammad; Zuhria, Ismi; Yustiarini, Ima; Widjaja, Sauli Ari
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/4fdqtz59

Abstract

Introduction : CMV Retinitis is the most common opportunistic infection in HIV/AIDS patient. Ocular manifestations in HIV/AIDS have similar clinical features though the management therapies are different. Case Illustration : A 47-year-old man was presented with blurred vision on LE since 4 months. Patient was diagnosed with HIV/AIDS since 2 years. Patient only had light perception on LE, and 5/10 on RE. The LE anterior segment showed flare and cell indicating active anterior uveitis. The LE posterior segment revealed extensive hemorrhage and exudate known as ‘pizza pie’ appearance, and cotton wool spot with multiple ischemic areas on RE. Laboratory tests revealed reactive IgG CMV and very low CD4 count (4 cell/?l). Patient was also diagnosed with Tinea Corporis, Scabies, and Pneumocystis carinii pneumonia. Oral Valganciclovir 900 mg was administered twice a day for 3 weeks, along with anti- retroviral therapy. Discussion : The anterior uveitis and ‘pizza pie’ appearance with positive CMV IgG indicate CMV Retinitis in fulminant form. Cotton wool spot found in the RE leads to retinal microvasculopathy due to HIV invading the vascular endothelium and causing increased plasma viscosity. This patient only had 4 cell/?l CD4 which indicates severe immune deficiency. If not treated immediately, patients with CD4 count <50 are at higher risk of contralateral eye involvement. Oral Valganciclovir was chosen considering the multiple opportunistic infections the patient had. Conclusion : It is important to distinguish CMV retinitis with other HIV/AIDS ocular manifestations. The choice of therapy needs be considered with the overall condition of patient.
Co-Authors Alphania Rahniayu Angeline Hartadhi Asti, Annisa Kinanti Athi Purnasari Bambang Hermanto Bening, Daya Banyu Cinintha Nandini Devi Sarah Intan Permatasari Doemilah, Ratna Dwita Permatasari Eddy Bagus Wasito Fadia Ghaisani Ferdian Ramadhan Firmansjah, Muhammad Hari Basuki Notobroto Hendrian Dwikoloso Soebagjo Hidayat, Shofa Annesa I'tishom, Reny Indriaswati, Dyah Kusworini Jamaluddin Jamaluddin Komaratih, Evelyn Lutfi, Delfitri Maria Astrid Claudia Monica Rizky Wigianita Muhammad Fariz Muhammad Vitanata Arfijanto, Muhammad Vitanata Nila Kurniasari Nurwasis Nurwasis Nyilo Purnami Prakoeswa, Camilla A. Prastyani, Reni Rahmawati, Lita Diah Ramadhani, Amelia Safitri Ratih Justitia Kartika Rifat Nurfahri Ruth Anastasia S.Pd. M Kes I Ketut Sudiana . Sarasati, Fani Septian Dwi Prabowo Soebagjo, Hendrian Dwikoloso Susy Fatmariyanti Widjaja, Sauli Ari WINARTO Yustiarini, Ima