OCULAR MANIFESTATIONS IN HIV-RELATED LYMPHOMA PATIENTS - INFLUENCE OFLYMPHOMA AND RELATED TREATMENT

Twenty-one consecutive HIV-related lymphoma patients were ophthalmolog ically observed (mean follow-up, 24.9 months) to evaluate the incidenc e of ocular involvement. Six of 21 patients already had AIDS at lympho ma diagnosis and received a moderate lymphoma treatment, whereas 12 of the other 15 were intensively treated. No statistical difference betw een HIV-related lymphoma patients and 40 HIV-positive control group pa tients (same clinical status; mean ophthalmologic followup, 18.9 month s) was found concerning the incidence of HIV-related retinal microangi opathy (P, 0.9), cytomegalovirus retinitis, and toxoplasmic retinochor oiditis (P, 1, respectively). Nevertheless, in HIV-related lymphoma pa tients all the opportunistic ocular infections were found in those who already had AIDS at lymphoma diagnosis, with a statistical significan t difference (P, 0.0158; odds ratio, 14.29). No differences were detec ted in the two groups of patients concerning the clinical course of th e opportunistic ocular infections. It was concluded that (1) the prese nce of lymphoma per se has a marginal influence on the development and clinical course of opportunistic ocular infections; (2) the incidence of these infections in HIV-associated lymphoma patients is mostly rel ated to the grade of immunodeficiency that preceded lymphoma diagnosis ; (3) the lymphoma treatment may increase the risk of opportunistic oc ular infections only in patients who had full-blown AIDS before the ap pearance of lymphoma, whereas it appears to have no influence even if it is administered intensively in HIV patients without severe immunode ficiency before lymphoma diagnosis.