S P Holland1, C W Chang, M Vagh, P Courtright. 1. British Columbia Centre for Epidemiologic and International Ophthalmology, Department of Ophthalmology, University of British Columbia, St. Paul's Hospital, Vancouver, BC.
Abstract
BACKGROUND: We noted a number of patients with unusual fine, stellate corneal endothelial deposits. The distribution of the deposits appeared to be concentric, involving mostly the periphery. We postulated that the changes might be related to the use of rifabutin rather than to cytomegalovirus (CMV) retinitis. We conducted a study among patients infected with HIV to assess the factors associated with these corneal changes. METHODS: All patients with HIV infection or AIDS who presented to an ocular AIDS clinic in Vancouver between May 16 and July 4, 1996, were examined for the presence of corneal endothelial deposits. The clinical history was noted in a masked fashion. RESULTS: Of the 162 patients examined, 25 showed fine, diffuse, white, stellate corneal endothelial deposits occurring predominantly in the periphery. The presence of the deposits was associated with rifabutin use (odds ratio 5.6, 95% confidence interval 2.5 to 12.9) independent of the presence of CMV retinitis, the CD4 count, the presence of uveitis and use of other medications. INTERPRETATION: Corneal endothelial deposits found in patients with HIV infection are associated with rifabutin use independent of the presence of CMV retinitis. The deposits should be monitored to determine their clinical significance.
BACKGROUND: We noted a number of patients with unusual fine, stellate corneal endothelial deposits. The distribution of the deposits appeared to be concentric, involving mostly the periphery. We postulated that the changes might be related to the use of rifabutin rather than to cytomegalovirus (CMV) retinitis. We conducted a study among patients infected with HIV to assess the factors associated with these corneal changes. METHODS: All patients with HIV infection or AIDS who presented to an ocular AIDS clinic in Vancouver between May 16 and July 4, 1996, were examined for the presence of corneal endothelial deposits. The clinical history was noted in a masked fashion. RESULTS: Of the 162 patients examined, 25 showed fine, diffuse, white, stellate corneal endothelial deposits occurring predominantly in the periphery. The presence of the deposits was associated with rifabutin use (odds ratio 5.6, 95% confidence interval 2.5 to 12.9) independent of the presence of CMV retinitis, the CD4 count, the presence of uveitis and use of other medications. INTERPRETATION:Corneal endothelial deposits found in patients with HIV infection are associated with rifabutin use independent of the presence of CMV retinitis. The deposits should be monitored to determine their clinical significance.