Objective Analysis of Retinal Function in HIV-positive Children Without Retinitis Using Optical Coherence Tomography

Abstract

Purpose: To assess the retinal nerve fiber layer thickness in children with human immunodeficiency virus disease without cytomegalovirus retinitis or visual symptoms. Methods: Thirty-eight eyes of 19 human immunodeficiency virus-positive children (group A) with visual acuity of 20/20 or better, normal color vision testing and no ophthalmoscopically detectable disorders were prospectively examined. All subjects of group A had no history of cytomegalovirus retinitis and CD4 counts consistently above 100. Patients in group B (40 eyes of 21 patients) were human immunodeficiency virus-negative age-matched control subjects. Thickness of retinal nerve fiber layer along a 3.4-mm-diameter circle centered on the optic nerve head was evaluated using third-generation optical coherence tomography. CD8 T-lymphocyte count, presence of systemic infection, hemoglobin, hematocrit and serum β-microglobulin levels were also recorded. Results: The mean overall retinal nerve fiber layer thickness in groups A and B were 89.2 ± 24.01 μm and 102.82 ± 29.168 μm (SD) respectively. The difference was considered extremely significant (P < 0.0001). Group A had significantly thinner average nerve fiber layer in temporal, nasal, superior and inferior retinal areas. Conclusions: Significant retinal nerve fiber layer thinning occurs in human immunodeficiency virus-positive children with no visual impairment or ophthalmologic evidence or retinitis.

KEYWORDS:

• Human immunodeficiency virus infection
• optic nerve
• optical coherence tomography
• retinitis