AIDS virus threatens epidemic of blindness

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AIDS virus threatens epidemic of blindness

With more than forty million people infected with HIV/AIDS

worldwide, the threat of opportunistic infections, diseases that

affect people with weak immune systems, looms large. Loss of vision

and ocular complications are one of the most common ailments,

affecting 50 to 75 per cent of all AIDS patients.

India, now the nation with the largest number of HIV infections in

the world, faces an epidemic of blindness. According to a report

from the World Health Organisation, 10 to 20 per cent of people

living with AIDS may lose vision in one or both eyes. This could

translate into a staggering 10,00,000 people affected by vision loss

due to HIV.

Cytomegalovirus Retinitis (CMV) is by far the most common disease

affectintg vision in people with AIDS. It is a member of the herpes

virus group which causes such common illnesses as chicken pox,

mononucleosis and herpes I and II. Most healthy people carrying CMV

will have few, if any, symptoms. Once the virus enters the body

however, it lies dormant and can be reactivated. In the people with

AIDS it may cause serious disease, blindness and even death.

Without treatment, CMV destroys the retina, a thin, light, sensitive

tissue at the back of the eye. Like film in a camera, nerves in the

retina convert light into signals that the brain interprets as

sight. Once the disease beings, it generally causes blindness in 4

to 6 months. People with CMV retinitis also have a 25 to 40 per cent

chance of developing retinal detachment, a condition where the

retina separates from the nerves of the eye, often leading to a

complete loss of vision.

The symptoms of the disease depend on which part of the retina has

been affected by the virus. People with CMV can experience temporary

vision blackouts, foggy or blurred vision, loss of central or

peripheral vision, or see " floaters " , small dark specks moving

slowly through their visual field. An increase in the number

of " floaters " is an important early warning sign of CMV. Though

similar symptoms can occur in other retinal diseases, they are of

special concern in people infected with HIV. If a person living with

the HIV virus experiences any of these conditions, they should

immediately visit an ophthalmologist and have an eye examination.

Patients diagnosed with CMV retinitis are generally treated with one

of two antiviral medications, foscarnet and gancyclovir.

Administered intravenously, both drugs have high toxicity and may

lead to serious side-effects like kidney failure. Recently, a new

procedure called Intravitreal ganciclovir treatment has been

developed for CMV. Gancyclovir in pellet form is implanted in the

cavity of the eye allowing the slow release of the medicine over 5

to 8 months. This results in fewer side effects and a better

prognosis for people living with CMV.

To date, intravitreal ganciclovir treatment has not been available

in many parts of India including Mysore. In an effort to make the

procedure accessible to more people with CMV, Avinash Pathengay DO,

FRCs, a Retinal Consultant from the LV Prasad Eye Institute in

Hyderabad, made a presentation on intravitreal ganciclovir to

Ophthalmologists from Mysore at Asha Kirana Hospital on Oct. 1,

followed by a demonstration of the procedure on Oct. 2.

This programme was conducted in collaboration with Mysore Ophthalmic

Association (MOA), Mysore.

For details contact Asha Kirana Hospital, CA-1 Ring Road, Hebbal

Industrial Area, Mysore or call 5280466.

— Dr. S.N. Mothi, Chairman, Asha Kirana Hospital

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