Editors Ashok Garg MS, PhD, FIAO (Bel) FRSM, ADM, FAIMS, FICA
International and National Gold Medalist Medical Director Garg Eye Institute and Research Centre 235-Model Town,
Dabra Chowk Hisar 125 005 (India)
Scott W Cousins MD
Professor of Ophthalmology Duke Center for Macular Diseases Duke University Eye Center PO Box 3802
Erwin Road Durham, NC 27710 (USA)
Kirit Mody MS, FRCS
Chairman and Medical Director Salil Eye Clinic 506, Om Chambers August Kranti Marg,
Kemps Corner, Mumbai (India)
David Meyer MMed, FCOphth, PhD
Professor and Head Department of Ophthalmology Faculty of Health Sciences University of Stellenbosch
Tygerberg 7505 (South Africa)
Foreword Georges Baikoff
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Clinical Diagnosis and Management of AIDS (HIV) in Eye
© 2006, Editors
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2006
9788180618253
Typeset at JPBMP typesetting unit
Printed at Paras Press
4Dedicated to
- My Respected Param Pujya Guru Sant Gurmeet Ram Rahim Singh Ji for his blessings and motivation.
- My Respected parents, teachers, my wife Dr Aruna Garg, son Abhishek and daughter Anshul for their constant support and patience during all these days of hard work.
- My dear friend Dr Amar Agarwal, a leading International Ophthalmologist from India for his continued support and guidance.
—Ashok Garg
- My wife Grettel and my two daughters, Mandy and Lexie.
—Scott W Cousins
- My wife Anjana, son Salil and daughters Ipsuta and Abhipsa for their love and support.
—Kirit Mody
- My dear wife Marita who has inspired my all three children Deidre, Riegardt and Adelle to join me in sharing the joys of the medical profession.
—David Meyer
6CONTRIBUTORS
- A Azimzadeh
- Ophthalmology Department
- Labbafinejad Medical Centre
- Pasdaran Avenue
- Boostan 9 Street
- Tehran 16666 (Iran)
- Amod C Rizwana md
- Senior Consultant and Vitreo-retinal Surgeon
- Dept. of Ophthalmology
- University of Stellenbosch
- Cape Town (South Africa)
- Ankur Agarwal ms, mnams
- Aditya Jyot Eye Hospital Pvt. Ltd.
- Plot No. 153
- Road No. 9
- Major Parmeshwaran Road
- Opp. SIWS College
- Gate No. 3, Wadala
- Mumbai 400 031 (India)
- Arif Adenwala ms, dnb, frcs, ico
- Consultant Ophthalmologist
- P. Box No. 457
- Zulekha Hospital
- Sharjah (UAE)
- Ashok Garg ms, phd, frsm
- Medical Director
- Garg Eye Institute and Research Centre
- 235-Model Town
- Dabra Chowk
- Hisar 125 005 (India)
- Bhuvana Guha md
- Associate Professor of Medicine
- Dept. of Internal Medicine
- James H Quillen College of Medicine
- East Tennessee State University
- Johnson City, USA
- David Meyer mmed, fcophth, phd
- Professor and Head
- Dept. of Ophthalmology
- Faculty of Health Sciences
- University of Stellenbosch
- Tygerberg 7505 (South Africa)
- David S Chi md
- Professor of Medicine Immunology
- East Tennessee State University
- Johnson City
- Tennessee (USA)
- Derrick Smit md
- Dept. of Ophthalmology
- Faculty of Health Sciences
- University of Stellenbosch
- Tygerberg 7505 (South Africa)
- Farhad Ally md
- Dept. of Ophthalmology
- Faculty of Health Sciences
- University of Stellenbosch
- Tygerberg 7505 (South Africa)
- Guha Krishnaswamy md
- Associate Professor of Medicine
- Chief, Allergic Disease Section
- East, Tennessee State University
- Hitendra Mehta ms
- Chairman & Medical Director
- Adityajyot Eye Hospital Pvt. Ltd.
- Plot No. 153, Road No. 9
- Major Parmeshwaran Road
- Opp. SIWS College
- Gate No. 3, Wadala
- Mumbai 400 031 (India)
- Ian Robinson md
- Clinical Professor of Ophthalmology
- RC International AIDS Research Institute, Chicago (USA)
- Jayant B Mehta md
- Medical Director
- TB Control Programme
- First Tennessee Region
- Tennessee
- Johnson City (USA)
- Jes Mortensen md
- Consultant,
- The Eye Deptartment
- Orebro University Hospital
- SE-70185, Orebro
- (Sweden)
- J Leema ms
- Fellow-Vitreo Retina
- Adityajyot Eye Hospital Pvt. Ltd.
- Wadala, Mumbai 400 031
- (India)
- Kirit Mody ms
- Medical Director
- Salil Eye Clinic and Contact Lens Centre
- 506, Om Chambers
- Kemps Corner
- August Kranti Marg
- Mumbai (India)
- Mark Philip md
- Associate Professor of Ophthalmology
- RC International AIDS
- Research Institute
- Chicago (USA)
- Masoud Soheilian md
- Ophthalmology Department
- Labbafinejad Medical Centre
- Pasdaran Avenue
- Boostan 9 Street
- Tehran 16666 (Iran)
- Mohammad-Mehdi Sadoughi
- Ophthalmology Department
- Labbafinejad Medical Centre
- Pasdaran Avenue
- Boostan 9 Street
- Tehran 16666 (Iran)
- Mohana Majumdar ms
- Fellow-Vitreo Retina
- Adityajyot Eye Hospital Pvt. Ltd.
- Wadala, Mumbai 400 031
- (India)
- M Rezael Kanavi
- Ophthalmology Department
- Labbafinejad Medical Centre
- Pasdaran Avenue
- Boostan 9 Street
- Tehran 16666 (Iran)
- Richard D Dix phd
- College of Optometry and Rumbaugh-Goodwin Institute for Cancer Research
- Nova Southeastern University
- Fort Lauderdale
- Florida, 33328
- Salil Mehta ms
- Salil Eye Clinic and Contact Lens Centre
- 506, Om Chambers
- Kemps Corner
- August Kranti Marg
- Mumbai (India)
- Scott W Cousins md
- Professor of Ophthalmology
- Duke Center for Macular Diseases
- Duke University Eye Center
- Duke University, Box 3802
- Erwin Road, Durham
- North Carolina, 27710 (USA)
- S Natarajan ms
- Chairman and Medical Director
- Adityajyot Eye Hospital Pvt. Ltd.
- Plot No. 153, Road No. 9
- Major Parmeshwaran Road
- Opp. SIWS College
- Gate No. 3, Wadala
- Mumbai 400 031 (India)
Several decades ago, the discovery of the AIDS virus in human beings produced a worldwide shock revealing a new pathology in the face of which mankind remained helpless during a number of years.
Faced with this problem, the good news was that scientists the world over joined their efforts and exchanged their information in order to discover the virus, define it and then to suggest efficient therapies to treat not only the related infections but also to halt the proliferation of the virus itself.
Ashok Garg and co-editors deserve credit for putting together a remarkable overview of what is known to date concerning this virus not just from a fundamental point of view but in particular its repercussions on the eye, diagnosis of the numerous infections and their treatment.
Through the combined efforts of immunology, chemotherapy and surgery, patients now have chance to recover a normal life and decent functional vision. The reader will appreciate the contribution from the very well-known international panel that took part in this book.
I am most grateful to Ashok Garg for his constant friendship and would like to take this opportunity to congratulate him for his dedication and contribution to this excellent book.
Georges Baikoff
md
Chirurgie Oculaire
Centre D'ophtalmologie Clinique Monticelli
88, Rue du Commandant Rolland, 13008
Marseille (France)
Tel.: 04 91 16 22 28
Fax: 04 91 16 22 25
E-mail: g.baik.opht@wanadoo.fr
12PREFACE
With a current prevalence of 100 million infected the world over and a projected prevalence of 200 million by year 2010 HIV/AIDS undoubtedly is one of most devastating disease pandemic of this century faced by the mankind. The disease—AIDS—was first detected in 1981 in Los Ageles, USA. Since then it has progressed rapidly in last 2 decades with 100 percent fatality and worldwide distribution. It is necessary to diagnose this disease in early stages to prevent multi-systemic diseases to fulminant especially AIDS-related infections in ophthalmology which can be devastating in terms of ocular morbidity and visual acuity. Extensive research is going on worldwide for the effective anti-HIV drug/injection therapy but with moderate success.
This multi-authored textbook has been written to impart knowledge to ophthalmologist in details about this dreaded disease which is spreading worldwide at the alarming rate. At present no other International Ophthalmology Book is available on this complex subject.
In this International Book there are 21 comprehensive chapters written by International Masters of this field covering all aspects from anatomy, pathophysiology of AIDS, investigations, various treatment modalities and recent advances, all treatment options including the latest drugs and injection therapy with complete pharmacotherapeutics have been included in this book for better clinical management of ophthalmic HIV infections. We are greatly indebted to all the contributors who are International experts in this field who have contributed their experience in the forms of chapters in a short span of time.
We are extremely grateful for the support extended by Sh JP Vij, (CMD), Sh Tarun Duneja (GM, Publishing) and all staff members of M/s Jaypee Brothers Medical Publishers, in the preparation of this book in a short time. We appreciate Sh JP Vij's invitation to write this book.
This book has been written in a true team spirit. We are quite hopeful this book will be useful companion to ophthalmologists dealing with HIV ophthalmic infections in their clinical practice.
—Editors
14ACKNOWLEDGEMENTS
We are grateful to World Health Organization (WHO) South East Asia Office, Cipla Foresight, International Society for AIDS prevention and Muller International HIV Society for their active support in the forms of providing brochures, figures and recommendations in the preparation of this International Book.