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EYE DISEASES IN THE PEDIATRIC HIV/AIDS PATIENTS AT THE NATIONAL HOSPITAL, ABUJA, NIGERIA
Abstract
Lack of data on eye disease in the pediatric HIV/AIDS population in Nigeria inspired this study. 168 confirmed HIV seropositive children (0-16 years) attending the Pediatric Hematology Clinic of the National Hospital, Abuja, whose parents or guardians gave informed consent, were recruited between December 2006 and May 2007.
Aim: To determine the spectrum of eye diseases in these HIV seropositive children.
Methods and Patients: The children were examined using the Silver & Sonsken’s Chart, Hundreds and thousands vision estimation, pen torch, pulsair tonometry, dilated ophthalmoscopy, slit lamp biomicroscopy and retinoscopy where indicated. Analysis was performed in the context of age, gender, educational status, documented mode of transmission, clinical presentation and laboratory data.
Results: Over the 6-month period, 336 eyes of 168 patients aged between 0.58 year (7 months) and 13.25 years [mean age 5.2 years; SD ± 2.72] were studied. The male to female ratio was 1:1. The prevalence of eye disease was 27.7% [95% CI 23.0%-32.7%] . Posterior segment signs were most prevalent (70.6%) and included: Retinal microangiopathy (43.5%); presumed toxoplasmosis (10.8%); glaucoma suspect (6.5%); maculopathy (5.4%); macula edema (3.3%) and salt and pepper retinopathy (1.1%). Anterior segment signs constituted 17.4%, including allergic conjunctivitis (10.8%); conjunctival microangiopathy (4.4%); herpetic keratitis (1.1%) and subconjunctival hemorrhage (1.1%). Lid signs (3.3%) included external hordeolum (2.2%) and presumed molluscum contagiosum (1.1%). Other signs were phthisis bulbi (2.2%) and refractive error (2.2%). Four patients (4.3%) had both anterior and posterior segment lesions.
Eye signs in 22.0% (74 eyes) were possibly HIV-related, including retinal microangiopathy, toxoplasmosis, maculopathy, conjunctival microangiopathy, phthisis bulbi, herpetic keratitis and molluscum contagiosum. The remaining lesions were probably incidental.
In view of the sparse national data and the attendant potential ocular consequence, regular screening and ophthalmic examinations of all HIV seropositive pediatric patients and the creation of a national data bank is strongly recommended.
