Ocular motor abnormalities in human immunodeficiency virus infection

Abstract

We studied ocular motor performance in 47 subjects with human immunodeficiency virus (HIV) infection and 25 normal control subjects. Saccade accuracy was the most sensitive measure, being significantly poorer for all four HIV-positive groups (asymptomatic, acquired immunodeficiency syndrome [AIDS] without dementia, and AIDS with dementia, and AIDS-related complex) than for control subjects. While saccade duration and peak velocity were not significantly different across groups, the scatter of saccade duration was increased in all HIV-positive groups. Saccade latency was not significantly affected. In both simple and complex antisaccade tasks, the asymptomatic, AIDS, and AIDS dementia groups made significantly fewer correct-way antisaccades than did control subjects. Latencies of correct-way antisaccades were increased for AIDS and AIDS dementia groups in the simple antisaccade trials, and for all HIV-positive groups in the complex trials. Fixation stability was significantly worse in the AIDS dementia group than in control subjects. Smooth pursuit gain was decreased in the asymptomatic, AIDS, and AIDS dementia groups for the least demanding trial. One or more ocular motor abnormalities were present in 15 (88%) asymptomatic subjects, 11 (69%) with AIDS-related complex, and 14 (100%) AIDS patients without or with dementia.

Human immunodeficiency virus type 1 infection of the brain

“…Eye movement abnormalities are common. These ocular motility disorders include slowed saccadic eye movements (252,268,315), hypometric saccades (76), overshoot dysmetria (114), fixational instability (76), and defective smooth pursuits (76). Currie and colleagues found these eye movement abnormalities useful predictive markers for the development of HIV-1 encephalopathy (76).…”

Neuro-ophthalmological disorders in HIV infected subjects with neurological manifestations

“…This finding is consistent with the result of previous clinical and electrophysiological studies, which have shown that abnormal saccades and smooth pursuits are present in HIV infected subjects including those without any other clinical manifestation of HIV infection. [23][24][25][26][27] These ocular movement disturbances are believed to be more frequent in subjects with HIV dementia. Some investigators have postulated that in asymptomatic HIV subjects they represent early manifestations of HIV dementia.…”

The neuro-ophthalmology of HIV-AIDS review of Neurobehavioral HIV Medicine

“…153,154 Saccadic problems in HIV positive patients include hypometric saccades, anticipatory saccades, wrong way saccades, abnormal antisaccades, fixation instability with saccadic intrusions and square wave jerks, slowed saccadic duration both for abducting and adducting saccades, and reduced saccadic velocity. [153][154][155][156] Smooth pursuit dysfunction includes saccadic pursuit and decreased smooth pursuit gain.…”

“…Abnormal saccades and smooth pursuit may be an early indicator of AIDS dementia complex (ADC) 153,155,157 characterized by progressive cognitive loss with behavioral problems and slowing of rapid motor movements. These ocular motility problems may be encountered even in patients without signs of ADC.…”