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This abstract is assigned to session AOB Poster session 1 - Glaucoma – Posterior segment/Retinal disease

Title	Blepharoptosis and external ophthalmoplegia associated with long-term antiretroviral therapy in human immunodeficiency virus-infected patients
Abstract Nr.	1031

Purpose	To present two cases of patients infected with human immunodeficiency virus (HIV) who developed a clinical picture of chronic progressive external ophthalmoplegia (CPEO) after long-term antiretroviral therapy.
Methods	In these 2 adult patients presenting with a clinical picture of CPEO, a biological and radiological work-up was performed to disclose myasthenia or classic CPEO of mitonchondrial origin. These patients share in common more than 10 years of antiretroviral therapy for HIV.
Results	The biological and radiological work up could not elicit myasthenia nor classic CPEO as the cause of our patient’s clinical picture. Acetylcholine receptor antibody and lactate titers were not increased. Orbital MRI was rather unremarkable.
Conclusion	We conclude that our patients have a CPEO-like syndrome relied to HIV disease and antiretroviral therapy, as already described in the literature. Antiretroviral therapy includes nucleoside reverse-transcriptase inhibitors and protease inhibitors, both of which are known causes of skeletal myopathy. Nucleoside reverse-transcriptase inhibitors interfers with mitochondrial DNA polymerase gamma. Mutations in the same enzyme have been demonstrated in patients with CPEO. Mitochondrial dysfunction might be the common link between these 2 similar pictures of different origins.
Conflict of interest	No

Authors 1

Last name	BOUAICH
Initials	K
Department	Hôpital universitaire Erasme
City	Bruxelles

Authors 2

Last name	Remiche
Initials	G
Department	Hôpital universitaire Erasme
City	Bruxelles

Authors 3

Last name	Goffard
Initials	JC
Department	Hôpital universitaire Erasme
City	Bruxelles

Authors 4

Last name	David
Initials	P
Department	Hôpital universitaire Erasme
City	Bruxelles

Authors 5

Last name	Van Nechel
Initials	C
Department	Hôpital universitaire Erasme
City	Bruxelles

Authors 6

Last name	Cordonnier
Initials	M
Department	Hôpital universitaire Erasme
City	Bruxelles