Abstract
Background: The prevalence of HIV and AIDS is causing an enormous public health burden. Its manifestations spare no organ. Ocular complications are mainly attributed to various opportunistic infections which are directly or indirectly caused by immune deficiency.Purpose and aim: The purpose of this study was to determine the effect of HIV and AIDS on subjective amplitude of accommodation of patients under treatment with antiretrovirals and then to compare their results to those of control subjects.Methods: The study took place over a period of 10 months. A quantitative study was carried out on 58 subjects (29 ± 5.5 years) with HIV and AIDS and 35 (28.67 ± 4.6 years) controls of similar age. Amplitude of accommodation was measured using the subjective Royal Air Force push-up method. The influence of CD4+ cell count was also recorded.Results: People with HIV and AIDS had lower mean amplitude of accommodation (5.69 ± 0.88 D) compared to controls (8.53 ± 1.2 D). The decrease in amplitude of accommodation did not show any correlation with the CD4+ cell count. Lower amplitude of accommodation exists in people living with HIV and AIDS when compared with age-related healthy people.Conclusion: The results suggest that patients with HIV and AIDS on antiretroviral drugs (ARVs) have reduced amplitude of accommodation and might experience presbyopia earlier in life than participants without HIV and AIDS. The reduced amplitude of accommodation could be the initial presentation of HIV infection before the systemic manifestation. The possible causes could be the direct neuronal infection by HIV-1, ARVs use, pathological changes of the lens and ciliary muscle or the sensory component of the visual system. It is unknown whether the reduced amplitude of accommodation occurred prior to antiretroviral therapy or represents an ongoing injury to the eye and visual system by the HIV.
Highlights
Since the first report of Pneumocystis carinii pneumonia some 36 years ago or so, the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV and AIDS) has been identified, and has emerged as one of the most challenging infectious diseases of our time.[1]
This study has found a significantly reduced amplitude of accommodation in patients with HIV and AIDS when compared with age-related limits for normal controls
The results support a previous study by Westcott et al.[17] who observed in their clinical practice that a significant proportion of their HIV-positive patients complained of accommodative difficulties at ages below that of onset of presbyopia
Summary
Since the first report of Pneumocystis carinii pneumonia some 36 years ago or so, the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV and AIDS) has been identified, and has emerged as one of the most challenging infectious diseases of our time.[1]. HIV and AIDS is a multisystem disease[3] that can affect various systems and organs of the body, including the eye (its manifestations spare no organ). The ocular manifestations of HIV and AIDS were first reported in 1982 by Holland et al.[6] Several reports have shown that 70% – 80% of HIV and AIDS patients will suffer optical and non-optical ocular manifestations at any point in time during the course of the disease.[7,8,9,10,11] The optics and biometry of the eye are affected in people with HIV and AIDS and blurriness of vision could be the first sign of its presence.[6]. The prevalence of HIV and AIDS is causing an enormous public health burden. Purpose and aim: The purpose of this study was to determine the effect of HIV and AIDS on subjective amplitude of accommodation of patients under treatment with antiretrovirals and to compare their results to those of control subjects
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