Szanyi Jana, Kremlacek Jan, Kubova Zuzana, Kuba Miroslav, Gebousky Pavel, Kapla Jaroslav, Szanyi Juraj, Vit Frantisek, Langrova Jana
Department of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech Republic.
Department of Infectious Diseases, Faculty Hospital in Hradec Kralove, Hradec Kralove, Czech Republic.
Doc Ophthalmol. 2017 Feb;134(1):45-55. doi: 10.1007/s10633-016-9570-x. Epub 2017 Jan 10.
The goal of the current study was to explore visual function in virally suppressed HIV patients undergoing combined antiretroviral therapy (cART) by using pattern-reversal and motion-onset visual evoked potentials (VEPs).
The pattern-reversal and motion-onset VEPs were recorded in 20 adult HIV+ patients with a mean age of 38 years and CD4 cell counts ≥230 × 10 cells/L of blood.
Nine out of 20 patients displayed VEP abnormalities. Pattern-reversal VEPs pathology was observed in 20% of subjects, and 45% HIV patients had impaired motion-onset VEPs. Five out of 16 neurologically asymptomatic HIV patients had prolonged motion-onset VEP latencies in both eyes. Four neurologically symptomatic patients displayed simultaneously abnormal motion-onset and pattern-reversal VEP latencies: monocular involvement was observed in two patients with Lyme and cytomegalovirus unilateral optic neuritis. Binocular involvement was noted in two patients with cognitive deficits. Correlation analysis between disease duration, CD4 cell count, HIV copies in plasma, MoCA and electrophysiological parameters did not show any significant relationships.
The functional changes of the visual system in neurologically asymptomatic virally suppressed HIV patients displayed higher motion-onset VEP sensitivity than in standard pattern-reversal VEP examinations. This promising marker, however, has no significant association with clinical conditions. Further exploration is warranted.
本研究的目的是通过使用模式反转和运动起始视觉诱发电位(VEP)来探索接受联合抗逆转录病毒疗法(cART)的病毒抑制的HIV患者的视觉功能。
对20名成年HIV阳性患者进行了模式反转和运动起始VEP记录,这些患者的平均年龄为38岁,CD4细胞计数≥230×10⁶个细胞/L血液。
20名患者中有9名表现出VEP异常。20%的受试者观察到模式反转VEP病理,45%的HIV患者运动起始VEP受损。16名神经无症状的HIV患者中有5名双眼运动起始VEP潜伏期延长。4名有神经症状的患者同时表现出运动起始和模式反转VEP潜伏期异常:2例莱姆病和巨细胞病毒单侧视神经炎患者出现单眼受累。2例有认知缺陷的患者出现双眼受累。疾病持续时间、CD4细胞计数、血浆中的HIV拷贝数、蒙特利尔认知评估量表(MoCA)和电生理参数之间的相关性分析未显示任何显著关系。
神经无症状的病毒抑制的HIV患者视觉系统的功能变化在运动起始VEP检查中比标准模式反转VEP检查表现出更高的敏感性。然而,这一有前景的标志物与临床状况无显著关联。有必要进行进一步探索。