AIDS-related optic neuropathy: a histological, virological and ultrastructural study.
BACKGROUND
Clinical and histopathological evidence of optic nerve axonal loss has been reported in AIDS patients without retinitis. The study was carried out to investigate the possible involvement of HIV-infected cells in the development of optic nerve degeneration.


METHODS
Optic nerves were obtained from eight AIDS patients and four normal controls. These nerves were morphologically and immunohistochemically analyzed. Additionally, using PCR amplification techniques, the retina and optic nerve samples obtained from three HIV-seropositive patients and one control were examined for the presence of HIV and cytomegalovirus antigens.


RESULTS
We noted various stages of axonal degeneration in the optic nerves obtained from AIDS patients in whom there was an absence of retinal findings. Characteristic glial changes involving hypertrophic astrocytes, vacuolated oligodendrocytes, and mononuclear phagocyte series cells were also seen in the AIDS optic nerves. HIV DNA was present in at least four of five optic nerves but in only one of five retinas. Control specimens were each negative for all cytomegalovirus and HIV antigens.


CONCLUSIONS
Degeneration in the optic nerve may be mediated by HIV-infected macrophages rather than by direct viral infection of neurons. Axonal degeneration due to AIDS at the level of the optic nerve can occur independently of retinal infection.
Sadun
A A
AA
Doheny Eye Institute, Los Angeles, CA 90033, USA.
Pepose
J S
JS
Madigan
M C
MC
Laycock
K A
KA
Tenhula
W N
WN
Freeman
W R
WR
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000956:Antigens, Viral / Q000032:analysis; D001253:Astrocytes / Q000737:chemistry / Q000648:ultrastructure; D001369:Axons / Q000737:chemistry / Q000648:ultrastructure; D001483:Base Sequence; D003587:Cytomegalovirus / Q000276:immunology; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000209:etiology* / Q000473:pathology; D005260:Female; D015488:HIV Antigens / Q000032:analysis; D006679:HIV Seropositivity / Q000150:complications; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006801:Humans; D008264:Macrophages / Q000821:virology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009410:Nerve Degeneration; D009836:Oligodendroglia / Q000737:chemistry / Q000648:ultrastructure; D009900:Optic Nerve / Q000737:chemistry / Q000648:ultrastructure / Q000821:virology; D009901:Optic Nerve Diseases / Q000473:pathology / Q000821:virology*; D016133:Polymerase Chain Reaction
D000956:Antigens, Viral; D017931:DNA Primers; D004279:DNA, Viral; D015488:HIV Antigens