Visual loss in HIV-associated cryptococcal meningitis: A case series and review of the mechanisms involved

Southern African Journal of HIV Medicine

Field Value
Title Visual loss in HIV-associated cryptococcal meningitis: A case series and review of the mechanisms involved
Creator Moodley, Anand Rae, William Bhigjee, Ahmed
Subject Health Sciences; Infectious Disease; Neurology;HIV infection cryptococcal meningitis; optic nerve; optic nerve sheath compartment syndrome; papilloedema; optic nerve infiltration
Description Permanent visual loss is a devastating yet preventable complication of cryptococcal meningitis. Early and aggressive management of cerebrospinal fluid pressure in conjunction with antifungal therapy is required. Historically, the mechanisms of visual loss in cryptococcal meningitis have included optic neuritis and papilloedema. Hence, the basis of visual loss therapy has been steroid therapy and intracranial pressure lowering without clear guidelines. With the use of high-resolution magnetic resonance imaging of the optic nerve, an additional mechanism has emerged, namely an optic nerve sheath compartment syndrome (ONSCS) caused by severely elevated intracranial pressure and fungal loading in the peri-optic space. An improved understanding of these mechanisms and recognition of the important role played by raised intracranial pressure allows for more targeted treatment measures and better outcomes. In the present case series of 90 HIV co-infected patients with cryptococcal meningitis, we present the clinical and electrophysiological manifestations of Cryptococcus-induced visual loss and review the mechanisms involved.
Publisher AOSIS
Date 2015-10-16
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/octet-stream text/xml application/pdf
Identifier 10.4102/sajhivmed.v16i1.305
Source Southern African Journal of HIV Medicine; Vol 16, No 1 (2015); 9 pages 2078-6751 1608-9693
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
Coverage Kwazulu Natal; South Africa — HIV positive; Over 18 years of age; cryptococcal meningitis
Rights Copyright (c) 2015 Anand Moodley, William Rae, Ahmed Bhigjee