Evaluation of Fundoscopic Findings in HIV Positive Patients in Relation to HAART and CD4 Count

Abstract

Aim: To evaluate the fundus findings in patients with HIV in correlation to highly active antiretroviral therapy (HAART) and CD4 count. Materials and Methods: It was a hospital based observational study. It was conducted from December 2014 to September 2016 in the Ophthalmology Department, Bharati Hospital, Sangli. A total of 195 registered HIV patients on HAART were selected for the study. Informed written consent of the subjects to participate in the study was taken. Patients of both sexes of any age group were included. Patients who did not give consent for the study were excluded. Result: The mean age of study subjects was 40.49 years. 83.6% subjects had a best corrected visual acuity (BCVA) between 6/6 to 6/9 in the right eye, 82.6% had BCVA between 6/6 to 6/9 in the left eye. Visual acuity was below 6/60 in 5.1% subjects. The most common anterior segment pathology was cataract (8.2%), corneal opacity (2.1%), pterygium (2.1%) and pseudophakia. CD4 count above 500 cells/mm 3 was seen in 28.7% cases while below 250 cells/mm 3 was seen in 29.3% cases. The mean age of study subjects was 40.49 years with 51.8% between 21-40 years. Female predominance was observed in study group with 57.9% females to 42.1% males. The prevalence of ophthalmic manifestations in HIV patients on HAART was observed as 37.9%. Prevalance of posterior segment manifestations was 19.5%. Prevalance of ophthalmic pathology increased as CD4 count decreased (250 cells/mm 3). Conclusion: In the present study, significant posterior segment manifestations were seen in HIV positive patients on HAART. Low CD4 count is a risk as well as predictor for ocular manifestations. Advent of HAART has reduced the prevalence of ocular manifestations. Routine referral system for ocular evaluation from other medical departments is mandatory for timely diagnosis of the vision threatening conditions. It is therefore recommended that eye care should be a part of medical care in the management of patients on HAART.

Ocular manifestations and refractive errors among people living with HIV in Pune, India: a cross-sectional study

“…19 However, the prevalence of cataract in our study population was higher than that reported amongst PLHIV elsewhere in India. [20][21][22] This might be owing to the use of slit lamp and dilated fundus examination conducted in all individuals who did not improve to 6/6, where even small lenticular opacities would have been detected. A report on cataract risk in HIV-infected individuals stated that compartmentalized residual intraocular HIV viremia, despite ART, and secondary chronic inflammation could be factors promoting cataract in these individuals.…”

Evaluation of correlation between ocular manifestations with CD4+ count in HIV patients: a cross-sectional study

“…Ocular manifestation may be the primary presentation of HIV. The eye is an organ with wide spectrum of HIV-related manifestation, and the disease can present with adnexal, anterior segment, posterior segment, orbital, and neuro-ophthalmic manifestation [5].…”