Index

Clinical Diagnosis and Management of AIDS (HIV) in Eye Ashok Garg, David Meyer, Kirit Mody, Scott W Cousins

1:Human Immune System
- INTRODUCTION
- INNATE (NON-SPECIFIC) IMMUNITY
- ACQUIRED (SPECIFIC) IMMUNITY
- AUTOIMMUNITY AND IMMUNOLOGICALLY PRIVILEGED SITES
2:Immunology and the Eye
- HISTORICAL PERSPECTIVES
- INNATE IMMUNITY
  - First Line Immunity
- SPECIFIC IMMUNITY—ADAPTIVE IMMUNITY
  - The B-Cell
  - The T-cells
- THE IMMUNITY OF THE EYE
  - The Afferent Limb
    - Central Processing
  - The Efferent Limb
- AUTOIMMUNE RESPONSE IN THE EYE
  - Role of the S Antigens
    - Clinical Case
- SUMMARY
3:History and Introduction of HIV
4:Etiology and Pathophysiology of AIDS
- INTRODUCTION
- ETIOLOGY
- MORPHOLOGY
  - Major Antigens
  - Genes
- IMMUNOPATHOGENESIS OF HIV DISEASE
- NATURAL COURSE OF HIV INFECTION
5:Ocular Manifestations of AIDS
- INTRODUCTION
- POSTERIOR SEGMENT MANIFESTATIONS
- NEURO-OPHTHALMOLOGIC MANIFESTATIONS
- ORBITAL MANIFESTATIONS
6:Investigations in AIDS in Ophthalmology
- INTRODUCTION
- HIV VIROLOGY
- OCULAR FINDINGS IN AIDS
  - CMV Retinitis
  - Role of PCR
- INVASIVE DIAGNOSTIC TECHNIQUES FOR RETINAL DISEASE
  - Operative Technique
  - Operative Technique
7:Antiretroviral Drug Therapy of Ocular Infections in AIDS
- INTRODUCTION
- HIV-RELATED RETINOPATHY
- OPPORTUNISTIC INFECTIONS OF THE EYE
  - Cytomegalovirus (CMV) Retinitis
  - Cryptococcal Infection
  - Toxoplasma Infection
  - Pneumocystis carinii Choroiditis
- NONOPPORTUNISTIC INFECTIONS
  - Herpes Zoster Ophthalmicus
  - Herpes Simplex
  - Viral Disease of Eyelids
  - Syphilitic Uveitis
  - Choroidal Tuberculosis
- TUMOR INVOLVEMENT
  - Kaposi's Sarcoma
  - Lymphoma of Orbit
  - Squamous Cell Carcinoma of Conjunctiva
- NEURO-OPHTHALMOLOGICAL MANIFESTATIONS
- CUTANEOUS HYPERSENSITIVITY REACTIONS
- HIV IN OCULAR STRUCTURES
- OCULAR MANIFESTATIONS OF HIV INFECTIONS IN CHILDREN
- ANTIRETROVIRAL THERAPY OF OCULAR INFECTIONS IN AIDS PATIENTS
  - Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  - Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  - Protease Inhibitors
  - Antiviral Metabolites
- CYTOMEGALOVIRUS INFECTION
- BREAKTHROUGH RETINITIS
  - Newer Modalities
    - Cidofovir/Zidofovir (HPMPC)
    - Protease Inhibitors in CMVR
- TOXOPLASMA INFECTION
- HERPES ZOSTER OPHTHALMICUS
- MYCOBACTERIUM TUBERCULOSIS
- MYCOBACTERIUM AVIUM INTRACELLULARE (MAI)
- OCULAR SYPHILIS
- ACUTE RETINAL NECROSIS
- PNEUMOCYSTIS CARINII CHOROIDITIS
- RECENT ADVANCES IN ANTIRETROVIRAL DRUG THERAPY
8:Ocular Syphilis and HIV Disease
- INTRODUCTION
- EPIDEMIOLOGY
- IMMUNOLOGY
- CLINICAL MANIFESTATIONS OF SYPHILIS IN HIV
- OCULAR SYPHILIS AND HIV
- SYPHILITIC UVEITIS
- NEURO-OPHTHALMOLOGIC MANIFESTATIONS
- NEUROSYPHILIS AND OCULAR SYPHILIS
- DIAGNOSIS
- CSF VDRL
- CSF FTA-Abs
  - Microbiological and Biochemical Tests
- TREATMENT OF OCULAR SYPHILIS IN HIV INFECTION
- CONCLUSION
9:External Ocular and Adnexal Signs that Alert to a Diagnosis of HIV/AIDS
- INTRODUCTION
- NONINFECTIOUS MANIFESTATIONS
  - Conjunctival Microvasculopathy
    - Dry Eye
    - Allergic Conjunctivitis6
- OPPORTUNISTIC OCULAR AND ADNEXAL INFECTIONS
- BACTERIAL INFECTIONS
- PROTOZOAL INFECTIONS
  - Microsporidia Keratitis
- NEOPLASMS23
10:Immune Recovery Uveitis
- INTRODUCTION
- CONCLUSION
11:Ocular Toxoplasmosis
- INTRODUCTION
- HISTORY AND CLASSIFICATION
- CLINICAL CHARACTERISTICS
  - Systemic Manifestation
  - Ocular Manifestations
- PATHOGENESIS
- PATHOLOGY
- DIAGNOSIS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT
- PREVENTION
- COMPLICATION
- PROGNOSIS
- CONCLUSION
- ACKNOWLEDGMENTS
12:HIV and Ocular Tuberculosis
- INTRODUCTION
- PATHOGENESIS
- HIGH-RISK POPULATIONS
- MANIFESTATION OF OCULAR TUBERCULOSIS
  - Primary vs Secondary TB of the Eye
  - External Disease
- INTRAOCULAR DISEASE
- DIAGNOSIS
- TREATMENT
  - Ocular Toxicity of Antituberculosis Medications
    - Ethambutol
    - Isoniazid (INH)
- PREVENTION OF OCULAR TB
- CONCLUSION
13:Is Age-related Macular Degeneration an Infectious Disease? The Role of Cytomegalovirus Infection and Inflammation
- THE PROBLEM OF ARMD
- CONVENTIONAL WISDOM REGARDING ARMD PATHOGENESIS
- ARMD IS AN INFLAMMATORY DISEASE AND MACROPHAGES ARE MAJOR CONTRIBUTORS
- PATIENTS WITH ACTIVATED MACROPHAGES IN THE BLOOD HAVE MORE SEVERE ARMD
- WET ARMD IS ASSOCIATED WITH CHRONIC CYTOMEGALOVIRUS (CMV) INFECTION
- MICE LATENTLY INFECTED WITH MURINE CMV DEVELOP MORE SEVERE EXPERIMENTAL CNV, AND THIS PHENOMENON IS ASSOCIATED WITH HIGHLY ACTIVATED MACROPHAGES BUT NO EVIDENCE OF CMV RETINITIS OR RETINAL VIRAL INFECTION
- IMPLICATIONS
14:Ocular HIV in the Pediatric Population
- INTRODUCTION
- EPIDEMIOLOGY OF THE PEDIATRIC HIV EPIDEMIC
- OCULAR MANIFESTATIONS OF HIV IN THE PEDIATRIC POPULATION
- CONCLUSION
15:Sterilization and Disinfection of HIV in Ophthalmology
- AIDS AND DISINFECTION IN RELATION TO OPHTHALMOLOGY
- PHYSICAL METHODS
- CHEMICAL METHODS
  - Ethylene Oxide (C2H4O)
  - Formalin
    - Precautions when using Formalin
- SOAKING IN LIQUID CHEMICALS
16:Vitrectomy in CMV Retinitis
- CHOICE OF SURGICAL PROCEDURE
17:Recent Management of CMV Retinitis
- GANCICLOVIR PHARMACOKINETICS
  - Intravitreous Ganciclovir
    - Technique
  - Vitreoretinal Surgery
18:Update on Anti-HIV Therapy
- METHODOLOGY FOR SEARCHING NEWER DRUGS
- DESCRIPTION OF INDIVIDUAL DRUGS
19:Strategies for HIV Prevention
- INTRODUCTION
- HIV PREVENTION
20:An Experimental Model of AIDS-related Cytomegalovirus Retinitis in Mice with Retrovirus-induced Immunosuppression
- INTRODUCTION
- CONCLUSIONS
- ACKNOWLEDGEMENTS
21:Pictorial Ophthalmic Manifestations of HIV

INDEX

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Chapter Notes