ART-linked lens opacity: Unveiling the connection

A 17-year-old male with perinatally acquired HIV on long-term ART (Tenofovir, Lamivudine, and Dolutegravir) for 9 years, presented with painless diminution of vision in the right eye. No systemic or ocular opportunistic infections were reported. Best-corrected visual acuity was counting fingers close to face in the right eye and 20/20 in the left. Slit-lamp examination showed a pearly white cataract in the right eye and an early posterior subcapsular opacity in the left Fig. 1a. Right eye fundus view was obscured; left eye posterior segment was normal. Postoperative appearance showed a clear visual axis with PCIOL in situ Fig. 1b.Figure 1: (a) Preoperative clinical photograph showing a pearly white cataract in the right eye of the patient. (b) Postoperative photograph of the same eye following uncomplicated phacoemulsification with posterior chamber intraocular lens (PCIOL) implantationMitochondrial toxicity from nucleoside analogs1 and prolonged HAART exposure contributes to oxidative stress, leading to premature cataractogenesis.2,3 Authors contributions Dr. Ropfuleno Peseyie: Literature Search, Clinical Studies, Data Acquisition, Data Analysis, Statistical Analysis, Manuscript Preparation, Manuscript Editing, Manuscript Review; Dr. Amit Mehtani: Concept, Design, Supervision, Definition of Intellectual Content, Statistical Analysis, Manuscript Editing, Manuscript Review; Dr. Kashish Modi: Literature Search, Clinical Studies, Data Analysis, Manuscript Editing, Manuscript Review. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patients understands that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.