title: Assessment of retinal function in patients with HIV without infectious retinitis by multifocal electroretinogram and automated perimetry.
abstract: OBJECTIVE
  To determine if multifocal electroretinogram (mfERG) testing shows abnormalities that correspond to perimetric defects in HIV positive patients without infectious retinitis.
  
  
  METHODS
  We studied three groups of patients: HIV negative controls, HIV high CD4 nadir patients (lowest CD4 T cell count is over 100) and low CD4 nadir patients (below 100 for over 6 months). Twenty-six HIV positive eyes and 16 HIV negative control eyes were studied by mfERG. A subset of 10 eyes also underwent computerized perimetry for comparison. We analyzed mfERG by hexagons as well as by quadrants and rings.
  
  
  RESULTS
  Of 103 hexagon locations there was no significant difference in the amplitudes P1 and N1 (nV/degree) between the three studied groups (p>0.05), similarly, the latencies were not different (p>0.05). All eyes with significant visual field defects at the 0.01 and 0.005 level (Humphrey pattern deviation; 24-2) were compared to mfERG amplitudes and latencies at those locations-there were no corresponding defects in mfERG data (p>0.2).
  
  
  CONCLUSIONS
  In the era of HAART there are still demonstrable visual field defects and other evidence of damage to the retinal nerve fiber layer in HIV patients. Our mfERG studies show that the damage appears to affect the inner retina, the outer retina is spared. Further studies of inner retinal structure and function are indicated to elucidate this process.
authors.affiliation: Joan and Irwin Jacobs Retina Center, Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, La Jolla, CA 92093-0946, USA.
authors.forename: Iryna
authors.initials: I
authors.lastname: Falkenstein
authors.forename: Igor
authors.initials: I
authors.lastname: Kozak
authors.forename: Ozcan
authors.initials: O
authors.lastname: Kayikcioglu
authors.forename: Lingyun
authors.initials: L
authors.lastname: Cheng
authors.forename: Dirk U
authors.initials: DU
authors.lastname: Bartsch
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Laurie D
authors.initials: LD
authors.lastname: Labree
authors.forename: William R
authors.initials: WR
authors.lastname: Freeman
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D004596:Electroretinography / Q000379:methods*; D015828:Eye Infections, Viral / Q000503:physiopathology*; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D012160:Retina / Q000503:physiopathology*; D012164:Retinal Diseases / Q000503:physiopathology*; D012173:Retinitis / Q000821:virology; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields