Ambiya Vikas, Sagar Amitabh, Patyal Sagarika, Mohanty A P
Graded Specialist (Ophthalmology), Military Hospital, Shillong, India.
Associate Professor, Department of Medicine, Armed Forces Medical College, Pune 40, India.
Med J Armed Forces India. 2012 Jul;68(3):214-21. doi: 10.1016/j.mjafi.2012.01.006. Epub 2012 May 31.
Most studies on the ocular manifestations of human immunodeficiency virus (HIV) infection are on cases of acquired immunodeficiency syndrome (AIDS), not including asymptomatic carriers of HIV. With this background, we proceeded to study all the HIV-infected individuals attending our centre, with the aim: a. To study the ocular manifestations of HIV. b. To correlate those manifestations with the CD4+ T-lymphocyte counts. c. To compare our findings with other studies.
A cross-sectional study involving a detailed ocular examination of 321 cases of HIV/AIDS was done. Automated perimetry, digital fundus photography and fundus fluorescein angiography were done for relevant cases. The last 125 cases were subjected to Schirmer's test and tear film break-up time.
We studied 321 male HIV cases (642 eyes), with a mean age of 36.78 years, mean CD4+ count of 276.54 cells/μL, 78.82% of them being on anti-retroviral therapy. Ocular manifestations were seen in 87 out of 321 cases, 72.41% of them being asymptomatic carriers of HIV. The ocular findings seen were conjunctival microvasculopathy, molluscum contagio-sum, dry eye, neuro-ophthalmic manifestations, anterior uveitis, posterior uveitis, and HIV retinopathy, only the last three of which had a significant association with CD4+ counts. The overall prevalence of ocular lesions also had a significant association with CD4+ counts.
Ocular manifestations are common in asymptomatic carriers of HIV. Anterior uveitis, posterior uveitis and HIV retinopathy have a significant association with CD4+ counts and are reliable indicators of low CD4+ count.
大多数关于人类免疫缺陷病毒（HIV）感染眼部表现的研究都集中在获得性免疫缺陷综合征（AIDS）病例上，未包括HIV无症状携带者。在此背景下，我们对到我们中心就诊的所有HIV感染者进行了研究，目的如下：a. 研究HIV的眼部表现。b. 将这些表现与CD4 + T淋巴细胞计数相关联。c. 将我们的研究结果与其他研究进行比较。
进行了一项横断面研究，对321例HIV/AIDS患者进行了详细的眼部检查。对相关病例进行了自动视野检查、数字眼底摄影和眼底荧光血管造影。对最后125例患者进行了泪液分泌试验和泪膜破裂时间检查。
我们研究了321例男性HIV病例（642只眼），平均年龄36.78岁，平均CD4 +计数为276.54个细胞/μL，其中78.82%正在接受抗逆转录病毒治疗。321例中有87例出现眼部表现，其中72.41%为HIV无症状携带者。观察到的眼部表现有结膜微血管病变、传染性软疣、干眼、神经眼科表现、前葡萄膜炎、后葡萄膜炎和HIV视网膜病变，其中只有最后三种与CD4 +计数有显著关联。眼部病变的总体患病率也与CD4 +计数有显著关联。
眼部表现在HIV无症状携带者中很常见。前葡萄膜炎、后葡萄膜炎和HIV视网膜病变与CD4 +计数有显著关联，是低CD4 +计数的可靠指标。
