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 ß-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. The third-generation optical coherence tomography can objectively detect early subclinical human immunodeficiency virus -associated visual functional loss.Table of Contents
Keywords: AIDS/HIV • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • optic nerve