Analysis of Visual Dysfunctions in HIV-positive Patients Without Retinitis

• Published in: American journal of ophthalmology 1997-08, Vol.124 (2), p.158-167
• Main Authors: MUELLER, A.J., PLUMMER, D.J., DUA, R., TASKINTUNA, I., SAMPLE, P.A., GRANT, I., FREEMAN, W.R.
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Biological and medical sciences; Color Perception; Contrast Sensitivity; Female; HIV Seropositivity - complications; HIV Seropositivity - physiopathology; HIV Seropositivity - psychology; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Male; Medical sciences; Middle Aged; Nervous System Diseases - etiology; Ophthalmoscopy; Prospective Studies; Psychophysics - methods; Retinitis - complications; Vision Disorders - complications; Vision Disorders - diagnosis; Vision Tests; Visual Field Tests
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(14)70780-9

To investigate visual dysfunctions in ophthalmoscopically normal human immunodeficiency virus (HIV)-positive patients and to correlate the results to the stage of HIV disease and neuropsychological status. Fifty-one randomly selected eyes (26 right, 25 left) of 51 HIV-positive patients with visual acuity measurements of 20/20 or better and no ophthalmoscopically detectable disorders were prospectively examined using achromatic and short-wavelength automated perimetry, color vision testing, and contrast sensitivity testing. CD4+ T-lymphocyte count, presence of systemic infection, hemoglobin, hematocrit, serum β2-microglobulin levels, and results of neuropsychological testing were also analyzed. On achromatic automated perimetry, 21.6% (11/51) of patients performed abnormally according to the mean defect and 27.5% (14/51) according to the Glaucoma Hemifield Test; 29.4% (15/51) performed abnormally on short-wavelength automated perimetry according to the mean defect and 23.5% (12/51) according to the Glaucoma Hemifield Test. On contrast sensitivity, 5.9% (3/51) of patients performed abnormally in the 1.5-cycles per degree (cpd) line, 2.0% (2/51) in the 3-cpd line, 23.5% (12/51) in the 6-cpd line, 25.5% (13/51) in the 12-cpd line, and 33.3% (17/51) in the 18-cpd line. On the Farnsworth-Munsell 100-hue test, 29.4% (15/51) of patients performed abnormally. After correction for multiple correlations, two statistically significant correlations were found: sum of log contrast sensitivity with achromatic automated perimetry and sum of log contrast sensitivity with the Farnsworth-Munsell 100-hue test. A significant percentage of HIV-positive patients with visual acuity of 20/20 or better and no ophthalmologic evidence of retinitis performed abnormally on visual psychophysical tests. The severity of visual dysfunction was not correlated with the stage of HIV infection or the degree of neuropsychological dysfunction.