Geier S A, Hammel G, Bogner J R, Kronawitter U, Berninger T, Goebel F D
Augenklinik, Klinikum Innenstadt der Ludwig-Maximilians-Universität, Germany.
Invest Ophthalmol Vis Sci. 1994 Jun;35(7):3011-21.
Color vision deficits in patients with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) disease were reported, and a retinal pathogenic mechanism was proposed. The purpose of this study was to evaluate the association of color vision deficits with HIV-related retinal microangiopathy.
A computer graphics system was used to measure protan, deutan, and tritan color contrast sensitivity (CCS) thresholds in 60 HIV-infected patients. Retinal microangiopathy was measured by counting the number of cotton-wool spots, and conjunctival blood-flow sludging was determined. Additional predictors were CD4+ count, age, time on aerosolized pentamidine, time on zidovudine, and Walter Reed staging. The relative influence of each predictor was calculated by stepwise multiple regression analysis (inclusion criterion; incremental P value = < 0.05) using data for the right eyes (RE). The results were validated by using data for the left eyes (LE) and both eyes (BE).
The only included predictors in multiple regression analyses for the RE were number of cotton-wool spots (tritan: R = .70; deutan: R = .46; and protan: R = .58; P < .0001 for all axes) and age (tritan: increment of R [Ri] = .05, P = .002; deutan: Ri = .10, P = .004; and protan: Ri = .05, P = .002). The predictors time on zidovudine (Ri = .05, P = .002) and Walter Reed staging (Ri = .03, P = .01) were additionally included in multiple regression analysis for tritan LE. The results for deutan LE were comparable to those for the RE. In the analysis for protan LE, the only included predictor was number of cotton-wool spots. In the analyses for BE, no further predictors were included. The predictors Walter Reed staging and CD4+ count showed a significant association with all three criteria in univariate analysis. Additionally, tritan CCS was significantly associated with conjunctival blood-flow sludging.
CCS deficits in patients with HIV disease are primarily associated with the number of cotton-wool spots. Results of this study are in accordance with the hypothesis that CCS deficits are in a relevant part caused by neuroretinal damage secondary to HIV-related microangiopathy.
已有报道称获得性免疫缺陷综合征（AIDS）或人类免疫缺陷病毒（HIV）疾病患者存在色觉缺陷，并提出了一种视网膜致病机制。本研究的目的是评估色觉缺陷与HIV相关视网膜微血管病变之间的关联。
使用计算机图形系统测量60例HIV感染患者的红色、绿色和蓝色颜色对比敏感度（CCS）阈值。通过计数棉絮斑的数量来测量视网膜微血管病变，并测定结膜血流淤滞情况。其他预测因素包括CD4 +细胞计数、年龄、雾化戊烷脒使用时间、齐多夫定使用时间以及沃尔特·里德分期。使用右眼（RE）的数据，通过逐步多元回归分析（纳入标准；增量P值 = < 0.05）计算每个预测因素的相对影响。使用左眼（LE）和双眼（BE）的数据对结果进行验证。
RE的多元回归分析中唯一纳入的预测因素是棉絮斑数量（蓝色：R = 0.70；绿色：R = 0.46；红色：R = 0.58；所有轴的P < 0.0001）和年龄（蓝色：R的增量[Ri] = 0.05，P = 0.002；绿色：Ri = 0.10，P = 0.004；红色：Ri = 0.05，P = 0.002）。齐多夫定使用时间（Ri = 0.05，P = 0.002）和沃尔特·里德分期（Ri = 0.03，P = 0.01）这两个预测因素在蓝色LE的多元回归分析中也被纳入。绿色LE的结果与RE的结果相当。在红色LE的分析中，唯一纳入的预测因素是棉絮斑数量。在BE的分析中，没有进一步纳入其他预测因素。在单因素分析中，预测因素沃尔特·里德分期和CD4 +细胞计数与所有三个标准均显示出显著关联。此外，蓝色CCS与结膜血流淤滞显著相关。
HIV疾病患者的CCS缺陷主要与棉絮斑数量相关。本研究结果符合以下假设，即CCS缺陷在很大程度上是由HIV相关微血管病变继发的神经视网膜损伤所致。
