Delhi Journal of Ophthalmology

Choroidal Detachment in Idiopathic CD4 Lymphocytopenia

Avadhesh Oli1, Raja Narayanan2,  INHS Asvini1, Navy Nagar, Colaba,2 Smt Kanuri Santhamma
1Department of Center for Vitreo Retina Services L. V. Prasad Eye Institute, Hyderabad, India
2Department of Center for Vitreo Retina Services L. V. Prasad Eye Institute, Mumbai , India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Raja Narayanan (MS)
Director and Network Head 
Department of Center for Vitreo Retina Services
L.V. Prasad Eye Institute, Mumbai, India.
Email: narayanan@lvpei.org


Received: 22-MAY-2020 Accepted: 26-JUL-2020 Published Online: 05-OCT-2021
DOI: https://dx.doi.org/10.7869/djo.699

Abstract
Usually reduction in CD4 cell count is seen with HIV infection, however CD4 lymphocytopenia in absence of HIV infection is called as Idiopathic CD4 Lymphocytopenia (ICL). The patients usually present with features of immunosuppression and opportunistic infections. Ophthalmic manifestations of this rare entity are not well known and very few cases are reported till date. We present a case of a 69 year old male patient who reported with profound reduction in his visual acuity in his left eye for 15 days. On examination of his left eye the  visual acuity was hand motion close to face and he had 360 degree choroidal detachment which was confirmed on a B scan. He had evidence of  subretinal fluid on optical coherence tomography (OCT). His detailed uveitis workup was unremarkable and HIV test was  negative twice repeated  at two occasions six weeks apart. His  CD4 count was 57 cells/ mm3  with all other investigations normal. This report highlights that iIdiopathic CD4 lymphocytopenia is a rare entity which usually presents as opportunistic infections as reported in the literature. This case of ICL had choroidal detachment which is unusual presentation of this rare entity. 


Keywords :Choroidal Detachment, Idiopathic CD4 Lymphocytopenia, Immunosuppression