Analysis of eye complications and blindness associated with HIV infection and AIDS

Abstract

Objective To investigate the clinical types of ocular complications in patients with human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome (AIDS), and analyze the main causes of visual impairment, so as to provide evidence for prevention and treatment of visual impairment. Methods The clinical characteristics and causes of blindness in 247 patients with HIV/AIDS were retrospectively analyzed. Routine examinations on visual acuity, intraocular pressure, slit lamp examination and mydriasis fundus were performed in all patients. Fundus photography or fundus fluorescein angiography (FFA) were performed in patients with fundus disease. The peripheral blood CD4+ T lymphocyte count was detected in laboratory, and blood/urine cytomegalovirus load (CMV-DNA) detection were carried out on patients with CD4+ T lymphocyte count<200/mm3. Results Among 247 patients with HIV/AIDS, 200 patients (310 eyes, 81%) had ocular complications. The incidence of cytomegalovirus retinitis (CMVR) was the highest [35% (70/200)], followed by keratitis [12% (24/200)] and dry eye [10.5% (21/200)]. And 13.2% (41/310) eyes were blind, which were mainly caused by CMVR [58.5% (24/41)]. In most of CMVR patients (65 cases, 92.9%), CD4+ T lymphocyte counts were lower than 100/mm3, and the disease get high incidence [77.1% (54/70] when CD4+ T lymphocyte count <50/mm3. Conclusions Sufficient understanding of complications of HIV/AIDS will lead to better treatment. CMVR is the main reason of blindness for patient with advanced AIDS. Therefore, it is suggested to complete CMVR test and complement treatment in early stage to avoid blindness and improve living quality for patients. Key words: Human immunodeficiency virus infection/acquired immunodeficiency syndrome; Eye complications; Blindness