White-noise field campimetry in HIV+ patients

Abstract

The first morphological changes in eyes with HIV infection are microvascular disease of the retina with cotton-wool spots and microaneurysms. The study was performed to find out if evidence of disturbances of ocular microcirculation can be established by non-invasive methods. Twenty-seven patients with HIV infection and without opportunistic infections underwent thorough ophthalmologic examination with threshold-oriented, suprathreshold perimetry (TAP 2000 ct, Oculus) and white-noise field campimetry (TEC, Oculus). Visual field examination was normal in 23 out of 27 patients (85%), whereas 4 patients showed relative field defects in at least one eye. In white-noise field campimetry 13 out of 23 perimetrically unaffected patients (56%) perceived scotomas in one or both eyes. These scotomas were not stable. Three of 4 patients with relative scotomas in the visual field had cotton-wool spots in the retina and showed a stable scotoma in campimetry. Visual acuity, IOP, and cup/disc ratio were within normal ranges. White-noise field campimetry complements the standard examination of patients with HIV and might be capable of indicating disturbances of ocular microcirculation by a non-invasive method before morphological changes in the retina can be seen.