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Detection of choroidal inflammation can prevent visual loss as the ocular lesion resolves fully with timely management.
The patient was started on antitubercular treatment (ATT) whereby the lung lesions improved but the ocular lesion showed initial clinical improvement followed by worsening.
It is interesting that multimodal therapy was effective in our case and local control for the metastatic ocular lesion was achieved.
There were 47.7% of patients who were not on HAART at the time of ocular lesion diagnosis; 69% of them had CD4 counts less than 200.
Interestingly, 27% of the patients were not on HAART and had persistently low CD4 counts for more than 6 months and did not develop any ocular lesion attributable to HIV.
When comparing patients on antiretroviral therapy (ART) and those not on ART with respect to the diagnosis of ocular lesions, it was found that 52.2% of patients were on ART at the time of ocular lesion diagnosis, 62% of them had CD4 < 200 while the rest had CD4 counts more than 200.
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Table 4 Comparison of presence of ocular lesions in patients with/without HAART in relation to CD4 counts With ART Without ART Ocular lesions 52.2 47.8 CD4 < 200 + OI 62 69 No ocular lesions CD4 < 200 31277 CD4 > 200 69733.
Out of 48.70% without any underlying systemic disease, 74.74% were without ocular lesions, while 25.26% had ocular lesions attributable to HIV (Table 3).
Frequent oral aphthous ulcers, genital ulcers, skin lesions and ocular lesions are the most common manifestations.
Overall, ocular lesions attributable to HIV/AIDS were found in 68.5% of the patients (Table 1).
Mean interval between HIV diagnosis and onset of ocular lesions was 2.43 years.
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