Severe enophthalmos and lagophthalmos secondary to HIV-associated lipoatrophy.
HIV-associated lipoatrophy has been closely linked to the use of the thymidine nucleoside reverse-transcriptase inhibitors stavudine and zidovudine. The lipoatrophy can have severe psychological effects and is associated with increased risk of metabolic disorders and cardiovascular disease. The authors present a case of a 45-year-old HIV-positive man who presented with severe bilateral enophthalmos (recession of the eyes) and lagophthamos (inability to fully close the eyes) from orbital fat atrophy. He had taken zidovudine for 8 years and stavudine for 13 years. Cessation of the causative drugs usually does not result in noticeable improvement of the lipoatrophy. Placement of bilateral orbital floor implants decreased our patient's orbital volume and substantially improved his eyelid function and cosmetic appearance.
Ophthalmology Department, California Pacific Medical Center, San Francisco, California, United States. Jennifer_DeNiro@yahoo.com
Jennifer Edith
JE
De Niro
Rona Z
RZ
Silkiss
D015841:Enophthalmos / Q000209:etiology*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index