East Afr Med J. 2008 Jan;85(1):39-45.. : Livestock Research for Rural Development
Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study .
Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward.
Subjects: HIV infected children.
Results: A total of 208 HIV infected children were examined. The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common finding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment findings in 31.3%. Conjunctival microvasculopathy (30 patients,14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal findings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment findings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment finding, followed by cotton wool spots (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infiltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic finding (93 patients, 44.7%). This study found that ocular findings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging)and to the severity of immune suppression (CD4 count).
Conclusion: The results of this study suggest a high prevalence of ocular findings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal finding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.