Ocular Manifestations of Kaposi Sarcoma: Insights from an HIV-Positive Patient and an Immunocompetent HIV-Negative Patient

Abstract

Kaposi sarcoma (KS) is a vascular neoplasm caused by human herpes virus-8 and is commonly associated with immunocompromised states such as acquired immunodeficiency syndrome. While ocular involvement is rare and typically occurs in human immunodeficiency virus (HIV)-positive patients, it can exceptionally present in HIV-negative, immunocompetent individuals. This report presents two cases of conjunctival KS: One in an HIV-positive patient and another in an HIV-negative patient. The patients were diagnosed and followed up at Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital. Written informed consent was obtained from the patients for the preparation of this case report. A 35-year-old HIV-positive male with a history of cutaneous and genital KS presented with a painless, reddish, hemorrhagic mass on the left inferior fornix and a firm mass on the lower eyelid. Surgical excision with adjuvant cryotherapy and amniotic membrane transplantation was performed. One year postoperatively, no recurrence or new lesions were observed. A 76-year-old immunocompetent female presented with a painless, progressively enlarging mass in the left inferior fornix. She underwent surgical excision, adjuvant cryotherapy, and amniotic membrane transplantation. Histopathology confirmed the diagnosis of KS, and at the 1-year follow-up, no recurrence or new lesions were observed. Ocular KS, though rare, can occur in both immunocompromised and immunocompetent individuals. This report highlights the importance of considering KS in the differential diagnosis of subconjunctival hemorrhage, even in patients without underlying immunosuppressive conditions. Both cases were successfully managed with surgical excision, adjuvant cryotherapy, and amniotic membrane transplantation, with no recurrence during follow-up. © 2025 Elsevier B.V., All rights reserved.