Retinal Findings in Chinese Patients with HIV Infection

Abstract

Background: The aim was to determine the prevalence of retinal lesions in patients infected by the human immunodeficiency virus (HIV) in China. Methods: The study included 105 consecutive patients with an HIV infection that underwent general and ophthalmologic examinations. In none of the patients was any systemic opportunistic infection found. The CD4+ T lymphocyte count determined in 89 patients revealed that 77 patients (87%) had a CD4+ lymphocyte count of >200 × 10⁶/l. Results: Retinal microvascular abnormalities were found in 12 subjects (11%) and local retinal nerve fiber layer defects in 13 patients (12%). Patients with fundus abnormalities compared to those with a normal fundus had a significantly (p = 0.013) lower CD4+ T cell count (166 ± 67) × 10⁶/l vs. 482 ± 33 × 10⁶/l) and did not vary significantly in visual acuity. Conclusions: In these HIV-positive Chinese patients attending a hospital for infectious diseases, retinal microvasculopathy and retinal nerve fiber layer defects were the most common fundus lesions, which were found in about 10% of the patients and which were inversely associated with the CD4+ T cell count, without marked effect on visual acuity.

Ophthalmic manifestations and risk factors for mortality of HIV patients in the post-highly active anti-retroviral therapy era

“…Ophthalmic involvements have been estimated to develop in 50% to 75% of patients with HIV infection 3,22,23 . Among the various ocular manifestations, HIV retinal microangiopathy and CMV retinitis are two of the most commonly reported manifestations 3,13–20,22–27 . Similarly in our study, CMV retinitis was the most common HIV‐related eye disease, affecting 19.2% of our patients, followed by HIV microangiopathy that was found in 12.6% of patients at presentation.…”

“…Comparison of the ophthalmic manifestations with other studies performed in Asia showed that the proportion of patients with CMV retinitis, HIV microangiopathy and IRU appeared to be comparable (Table 2). 13–20 …”

“…In the USA, the Longitudinal Study of Ocular Complications of AIDS (LSCOA) is being conducted to evaluate the changing epidemiology of ocular complications of HIV infection after the introduction of HAART 11,12 . Several retrospective studies have also reported the ophthalmic manifestations of HIV/AIDS patients in various Asian populations 13–20 . Despite the reduced incidence of CMV retinitis associated with immune recovery, new cases still continue to develop 21 .…”

“…11,12 Several retrospective studies have also reported the ophthalmic manifestations of HIV/AIDS patients in various Asian populations. [13][14][15][16][17][18][19][20] Despite the reduced incidence of CMV retinitis associated with immune recovery, new cases still continue to develop. 21 Moreover, new disease entities such as immune recovery uveitis (IRU) has emerged following the introduction of HAART.…”

HIV/AIDS in the Developing World

“…31 In Asia, HIV retinopathy is seen in 6% to 33% of patients with HIV/AIDS. [51][52][53][54]57 The consequences of CMV retinitis in these countries are significant, owing to the relatively poor availability of screening and treatment programs. 31 In a 2007 study from Thailand, CMV retinitis was the cause of bilateral blindness in nearly 20% of all patients.…”