Retinal nerve fiber layer evaluation in human immunodeficiency virus-positive patients.
OBJECTIVE
To determine the effect of human immunodeficiency virus (HIV) infection on topographic measures of the optic disk and the retinal nerve fiber layer.


METHODS
A cross-sectional study at the Acquired Immunodeficiency Syndrome (AIDS) Ocular Research Unit at the University of California, San Diego. Retinal nerve fiber layer thickness at the optic nerve head was evaluated using the Heidelberg Retinal Tomograph, a confocal scanning laser tomograph in 38 HIV-positive and 24 age-matched HIV-negative subjects.


RESULTS
HIV-positive patients without CMV retinitis showed significant differences from HIV-negative normal controls in a number of measures of the retinal nerve fiber layer. This indicated a loss of retinal ganglion cells in HIV-positive patients without retinitis. HIV-positive patients with CMV retinitis were worse in most measurements than both HIV-negative controls and HIV-positive patients without CMV.


CONCLUSIONS
Significant thinning of the retinal nerve fiber layer occurs in HIV-positive patients without infectious retinopathy, and there are further changes in the optic disk associated with CMV retinitis. Confocal scanning laser tomography may be of use in the diagnosis of early HIV-associated visual function loss.
Shiley Eye Center, Department of Ophthalmology, School of Medicine, University of California-San Diego, La Jolla, CA 92093-0946, USA. dplummer@ucsd.edu
D J
DJ
Plummer
D U
DU
Bartsch
S P
SP
Azen
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Max
A A
AA
Sadun
W R
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Freeman
D017088:AIDS-Related Opportunistic Infections / Q000473:pathology*; D000328:Adult; D003430:Cross-Sectional Studies; D017726:Cytomegalovirus Retinitis / Q000473:pathology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000473:pathology*; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D014054:Tomography; D014792:Visual Acuity