Ocular Adnexal Kaposi Sarcoma

Human herpesvirus 8 is associated with Kaposi sarcoma. Two aggressive variants of this tumor have been described: an endemic variety especially prevalent in Kenya and Nigeria and a second variant, epidemic Kaposi sarcoma, which was first noted in renal transplant recipients and in patients with AIDS. AIDS-associated Kaposi sarcoma may be found in visceral organs (the gastrointestinal tract, lung, and liver) in up to 50% of patients. Before the availability of potent antiretroviral therapy, ocular adnexal involvement occurred in approximately 20% of patients with AIDS-associated systemic Kaposi sarcoma (Fig 15-5). Histologic investigation shows spindle cells mixed with vascular structures. Treatment of Kaposi sarcoma consists of excision, cryotherapy, radiation, or a combination of these methods and is based on the clinical stage of the tumor as well as its location and the presence or absence of disseminated lesions.

Figure 15-5 Conjunctival involvement in Kaposi sarcoma; hemorrhagic conjunctival tumor.

(Courtesy of Elaine Chuang, MD.)

Figure 15-6 Slit-lamp photograph of cornea showing punctate epithelial keratitis caused by microsporidia.

Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.