Isquemic Maculopathy in Patients with Acquired Immunodeficiency Syndrome and CD4+ T-lymphocyte Count under 50 Cells/µL

Abstract

Abstract: : Purpose: To evaluate the incidence of isquemic macular changes in patients with human immunodeficiency virus (HIV) infection and CD4⁺ T-lymphocyte <50 cells/µL. Methods: Prospective consecutive study of nine HIV-infected adult patients sent from the AIDS clinic for consultation with CD4⁺ T-lymphocyte <50 cells/µL and best corrected visual acuity of 20/30 or better. All patients were receiving highly active anti-retroviral therapy (HAART). Patients with a history of systemic vascular disease, allergic to fluorescein or pregnant were excluded. Ophthalmic evaluation consisted of: visual acuity, slit lamp biomicroscopy, tonometry and dilated fundus exam followed by fluorescein angiography. The evaluation was always performed by one of the authors. Results: All patients were males with ages between 30 and 66 years (Mean=38.3). CD4⁺ T-lymphocyte count varied from 3 to 45 cells/µL (mean=28.3). Five patients (55.6%) presented isquemic macular changes in one or both eyes (figure bellow) although the only patient with visual complaints did not present ischemia. Conclusions: Ischemic macular changes may be present in HIV-infected patients with CD4⁺ T-lymphocyte <50 cells/µL regardless the presence of visual complaints. Further studies will be necessary to determine a possible relationship between ischemic maculopathy and low CD4⁺ T-lymphocyte count.  

Keywords: AIDS/HIV • clinical (human) or epidemiologic studies: ris • ischemia