Ophthalmology. 1997 Mar;104(3):445-53. Unique Identifier : AIDSLINE
PURPOSE: The authors examined electrophysiologic and psychophysical
measures of retinal function in patients infected with human
immunodeficiency virus (HIV) at different stages of infection, including
patients with cytomegalovirus retinitis CMVR). METHODS: All patients had
complete ophthalmologic examinations. Rod-mediated psychophysical
thresholds were measured using a modified two-color dark-adapted
perimetry technique. Rod-dominated full field flash electroretinograms
ERGs) were obtained as a function of flash intensity, followed by
cone-dominated ERGs. The 26 patients infected with HIV (26 eyes) were
categorized into three groups. Six patients were infected with HIV but
had not progressed to acquired immunodeficiency syndrome (AIDS), and 14
had AIDS. Six patients had CMVR with less than 10% of the retina
involved. The data were compared with results from age-similar control
subjects. RESULTS: Psychophysical thresholds as a function of retinal
eccentricity were elevated for each of the three stages of HIV
infection. The group of patients with CMVR had the greatest amount of
threshold elevation and threshold elevation increased with retinal
eccentricity. In addition, all three patient groups had abnormal
electroretinographic findings. Patients with CMVR were affected more
severely on all measures than were the other HIV-infected groups.
CONCLUSIONS: Results reveal that a diffuse functional retinal pathology
exists in eyes with the funduscopic appearance of localized peripheral
CMVR. Additionally, patients infected with HIV, including those without
cotton wool spots, may have abnormal retinal function.
*Cytomegalovirus Retinitis/PHYSIOPATHOLOGY *Electroretinography *HIV
Infections/PHYSIOPATHOLOGY *Photoreceptors/PHYSIOPATHOLOGY