Fundus characteristics of acquired immune deficiency syndrome in human immunodeficiency virus retinopathy

Abstract

Objective To observe the fundus characteristics of acquired immune deficiency syndrome (AIDS) with human immunodeficiency virus (HIV) retinopathy.Methods Eighty eyes of 52 AIDS patients with HIV retinopathy were enrolled in this study.The patients included 42 males (67 eyes) and 10 females (13 eyes).The patients ages ranged from 16 to 78 years,with a mean age of (43±12) years.All patients' visual acuity,intraocular pressure,slit-lamp microscopy and mydriatic indirect ophthalmoscopy,fundus color photography and CD4+ T cell count was documented.Experienced ocular fundus doctors carried out fundus examinations.Retinopathy characteristics were recorded.Seventeen patients (24 eyes) were followed for a period between two days to two years,with a median of 125 days.We failed to follow up the remaining 35 patients (56 eyes) due to death or moving away.Results Among 52 patients (80 eyes),28 patients (56 eyes,70.0％) had bilateral HIV retinopathy and 24 patients (24 eyes, 30.0％) had unilateral HIV retinopathy.Cotton-wool spots (CWS),mostly located close to temporal peripapillary vessels,were found in 46 patients (72 eyes,90.0％).Six patients (eight eyes,10.0％) were found to have flaming or spotting hemorrhage located in posterior pole.Among 72 eyes with CWS,57 eyes were found to have CWS only and 15 eyes were found to also have retinal hemorrhage,mostly located near CWS.Among 24 eyes of 17 followed-up patients,three eyes of three patients were found with no significant changes during the less than two week follow-up.In 18 eyes of 11 patients,CWS or hemorrhage disappeared after one to three months without treatment and in five eyes new CWS or hemorrhage were found in other parts of the posterior pole.Three eyes of three patients initially considered as lint plaque-like lesions were eventually detected with CMVR as lesions during one to five months follow-up.Conclusion CWS are the most common ocular lesions in HIV retinopathy. Key words: Acquired immunodeficiency syndrome/complications; HIV infections/complications; Retinal degeneration/diagnosis; Disease attributes