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Ptosis in human immunodeficiency virus-infected patients under long-term antiretroviral treatment

2025Journal article Open access
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dc.contributor.authorSantos Silva, C
dc.contributor.authorNunes Vicente, B
dc.contributor.authorMartins, B
dc.contributor.authorFonseca, AC
dc.contributor.authorCoelho, P
dc.contributor.authorRoque, R
dc.contributor.authorCota de Medeiros, F
dc.contributor.authorOliveira Santos, M
dc.contributor.authorde Carvalho, M
dc.date.accessioned2025-01-19T15:40:26Z
dc.date.available2025-01-19T15:40:26Z
dc.date.issued2025
dc.description.abstractObjective: To present cases of ptosis in HIV-1 patients on long-term antiretroviral therapy (ART) and review the existing literature. Methods: Five HIV-1-positive patients with slowly progressive bilateral ptosis underwent a comprehensive diagnostic evaluation, including imaging studies, neurophysiological testing, muscle biopsy, and genetic analysis. A literature review was conducted. Results: On clinical examination, all patients presented with bilateral symmetrical non-fatigable ptosis, three exhibited facial lipoatrophy and two also had mild multidirectional ophthalmoparesis and all had ocular abnormalities in Hess screen test. Additionally, one patient displayed proptosis, three had floppy lower eyelids, and four presented with exotropia. Anti-acetylcholine receptor antibodies were negative in all patients. Brain magnetic resonance imaging (MRI), motor unit potential analysis, and single-fiber electromyography were unremarkable. Orbital MRI revealed introrbital fat expansion in one patient, and limb muscle biopsies were inconclusive in two cases. Blood genetic testing for chronic progressive external ophthalmoplegia was negative in all patients. A total of 30 similar cases have been documented in the literature, with some studies reporting key findings such as muscle histology indicative of mitochondrial myopathy, MRI revealing patchy extraocular muscle hyperintensity, and muscle genetic testing identifying mitochondrial deoxyribonucleic acid (DNA) deletions. Ptosis surgical repair appears to be the most effective treatment. Conclusion: HIV patients on long-term ART may develop ocular muscle involvement due to mitochondrial dysfunction, with bilateral ptosis being the primary manifestation. Diagnosis is challenging and requires the exclusion of other conditions. Ptosis surgery can significantly improve quality of life.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClin Neurol Neurosurg . 2024 Dec 13:249:108690.pt_PT
dc.identifier.doi10.1016/j.clineuro.2024.108690pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/53905
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectTerapia Antirretroviral de Alta Atividade/efeitos adversospt_PT
dc.subjectBlefaroptosis/induzido quimicamentept_PT
dc.subjectAntiretroviral Therapy, Highly Active/adverse effectspt_PT
dc.subjectBlepharoptosis/chemically inducedpt_PT
dc.titlePtosis in human immunodeficiency virus-infected patients under long-term antiretroviral treatmentpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage108690pt_PT
oaire.citation.titleClinical Neurology and Neurosurgerypt_PT
oaire.citation.volume249pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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