PRESUMED UVEITIS SECONDARY TO LEISHMANIA IN A HIV PATIENT HOSPITAL UNIVERSITARIO DE FUENLABRADA Mª Isabel Gabarrón Hermosilla Fredy Ruiz Esther Corredera Salinero

INTRODUCTION 51 years old HIV + patient asking for pain and decreased visual acuity in his LE (amblyopic RE) Personal History HIV + since 2011 under anti-retroviral therapy Relapsed visceral leishmania since March 2012

OCULAR EXPLORATION VA (LE): 0,5 (RE): CF BMC: bilateral granulomatous anterior uveitis IOP: 24 7 32 mmHg

INITIAL TREATMENT Topical steroids + dorzolamide/timolol Oral aciclovir SYSTEMIC UVEITIS WORK OUT: - PCR in aqueous humor : + VEB NO CLINICAL IMPROVEMENT

MODIFICATIONS IN TREATMENT We stopped oral aciclovir and started systemic leishmania treatment with amphotericinB ( Ambisome® 200mg/day x 21 days) Same topical management. Great improvement in 3 weeks until total resolution of inflamation, and normalization of IOP and return of VA to 1.

A MESSAGE TO TAKE HOME THANK YOU A bilateral granulomatous uveitis in a HIV+ patient with previous history of visceral leishmaniasis should make the clinician suspicious of ocular leishmaniasis Prompt intervention with systemic therapy is necessary to optimize the outcome Both, the infection and the inmune reaction against lingering parasites may play a key role in the pathogenesis of these uveitis. THANK YOU