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Jing Grace Wang, Nathaniel Nataneli; Evaluating corneal sensation in patients with HIV Infection. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6160.
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© ARVO (1962-2015); The Authors (2016-present)
Distal symmetric polyneuropathy (DSP) has been recognized as a common neurologic complication of Human Immunodeficiency Virus (HIV) infection. Currently, there is no gold standard for the diagnosis of HIV DSP. Its diagnosis remains based on a combination of clinical signs and symptoms, such as reduced ankle reflexes, reduced pinprick sensation, or reduced vibration sensation in the feet. The purpose of this study is to compare the corneal sensation in patients with and without HIV infection, and investigate the possibility of using corneal sensitivity as a new quantitative testing that allows objective assessment of HIV DSP.
This is a retrospective chart review of patients who had an eye exam at the eye clinic at a community hospital in the Bronx, NY. Adult patients who are HIV-positive and who have no history of ocular surgery or topical medication use were enrolled into the study group. The control group consisted of HIV-negative patients who had no history of ocular surgery or topical medication use. Corneal sensation assessment was performed with a Cochet-Bonnet aesthesiometer. The data was statistically analyzed using excel.
22 HIV patients and 22 control patients were included in the study. The average of the central corneal sensation in HIV group is 56.6 ± 1.0 mm, compared to 59.3 ± 0.4 mm in control group (P = 0.004). The average of the peripheral corneal sensation in HIV group is 57.6 ± 0.9 mm, compared to 59.4 ± 0.2 mm in control group (P = 0.019). Viral load of HIV patients has a weak positive correlation with the sensation of the central cornea, but this correlation is not statistically significant (correlation coefficient of + 0.21, p = 0.321). CD4 value of HIV patients has no correlation with the sensation of the central or peripheral cornea (correlation coefficient of -0.05 and -0.08, respectively).
Both central and peripheral corneal sensation measurements are statistically significantly decreased in the HIV group compared with that of the the control group. Our preliminary results suggest that corneal sensitivity may potentially be used as an additional clinical tool that allows for objective assessment of HIV distal symmetric polyneuropathy. The results also suggest that ocular surface disease may be more difficult to manage in HIV positive patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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