Shigetoshi Nagataki

Ocular complications in patients infected with human immunodeficiency virus seen at the Acquired Immunodeficiency Syndrome Clinical Center

PURPOSE To examine the ocular complications in patients infected with human immunodeficiency virus(HIV) in Japan. METHODS The medical records of 322 patients seen at the acquired immunodeficiency syndrome(AIDS) Clinical Center from July 1, 1997 through December 31, 1998 were reviewed, and the HIV-associated ocular complications were correlated with serum CD 4+ T-lymphocyte counts. RESULTS Ocular complications were found in 51 patients: 35 cases with retinal microvasculopathy, 17 cases with cytomegalovirus retinitis(9 quiescent, 6 active, and 2 recurrent), and 1 case each with tuberculous uveitis, phthisis bulbi after necrotizing herpetic retinopathy, conjunctival Kaposis sarcoma, papilledema, divergence palsy, hemianopia, and abducens palsy. Retinal microvasculopathy was present in patients with CD 4+ T-lymphocyte counts above 500/mm3, but was more common in patients with cell counts below 200/mm3. Among 6 patients with active cytomegalovirus retinitis, 5 patients had a CD 4+ T-lymphocyte count below 50/mm3 at the onset of retinitis, while one patient developed retinitis after the cell count increased to over 200/mm3 with highly active antiretroviral therapy. CONCLUSION Cytomegalovirus retinopathy may occur in patients with a CD 4+ T-lymphocyte count of more than 200/mm3.

Effect of nipradilol on aqueous flow in glaucoma patients treated with timolol

The effect of nipradilol solution (KT-210) on aqueous flow was evaluated using fluorophotometry in 10 patients (6 primary open-angle glaucoma and 4 ocular hypertension) treated with timolol for more than one month. A single dose of 0.5% timolol was instilled into both eyes at 8 AM, and 0.25% KT-210 or placebo was instilled into both right and left eye at 11 AM; the treated eye was chosen randomly. Aqueous flow was measured every hour from 9 AM to 3 PM. There was no significant difference in pretreatment aqueous flow between the two eyes; 1.98 +/- 0.53 microliters/min in the KT-210 treated eyes, and 1.98 +/- 0.76 microliters/min in the placebo treated eyes. The flow measured 1 to 4 hours after KT-210 instillation was 1.66 +/- 0.69 microliters/min, 2.23 +/- 1.02 microliters/min, 2.20 +/- 0.67 microliters/min, and 1.68 +/- 0.64 microliters/min, respectively. This flow did not differ significantly from the flow in the placebo treated eyes (1.83 +/- 0.86 microliters/min, 1.79 +/- 0.69 microliters/min, 2.26 +/- 0.58 microliters/min, and 1.84 +/- 0.32 microliters/min).