Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 5 Issue 12

Retinal Manifestations in Acquired Immuno Deficiency Syndrome: A Clinical Study and their Relationship to CD4 Cell Count

Manoj S, Sameer I*, Sruthi P S and Pasupuleti Venkata Sarath Babu

Chaithanya Eye Hospital and Research Institute, Thiruvananthapuram, Kerala, India

*Corresponding Author: Sameer I, Department of Vitreo-Retinal Service, Chaithanya Eye Hospital and Research Institute, Thiruvananthapuram, Kerala, India.

Received: November 04, 2022; Published: November 09, 2022

Abstract

Background: HIV is a multisystem disorder causing a wide spectrum of diseases. Ocular manifestations which occur in 70-80% of HIV patients may be the initial presentation of a systemic infection in an asymptomatic patient. HIV-related ocular symptoms can vary depending on CD4+ T lymphocyte levels. 

Aim: To analyze the retinal manifestations of HIV/AIDS patients and to evaluate its association with CD4 cell counts.

Material and Methods: HIV patients with CD4T cell count < 200 cells/mm3 and WHO stage 4 disease irrespective of CD4 cell count were included in the study. Detailed history and ocular examination were undertaken along with systemic evaluation. 

Observations: Out of total 306 patients examined, 86 (28%) had retinal manifestations. Majority of patients belonged to age group 20-40 yrs (69%). Most common retinal manifestations were HIV retinopathy (19%), then CMV retinitis (6%). Retinal manifestations were more among those with CD4 count < 50 cells/mm3. In HIV positive patients with retinal manifestations, HIV retinopathy seen as comparatively early manifestation, while CMV retinitis seen as a late manifestation. There is increased risk for CMV retinitis in those with CD4 cell count <50 cells/mm3 which is statistically significant with p value <0.0001. HIV retinopathy is seen more in those with CD4 cell count between 50-200 cell/mm3 (26%) and this is statistically significant with p value < 0.045

Conclusion: Most common retinal manifestations in AIDS patients were HIV retinopathy and CMV retinitis, which has an inverse association with CD4 cell count of the patient. Our study highlights the importance of ophthalmological examination in HIV patients especially with low CD4 count, which can help in early diagnosis and management, which will considerably decrease the visual morbidity in such patients.

Keywords: HIV Infection; AIDS; Ocular Manifestations; HIV Retinopathy; CMV Retinitis

References

  1. Wilen CB., et al. “HIV: cell binding and entry”. Cold Spring Harbor Perspectives in Medicine 8 (2012): a006866.
  2. Jabs DA and Green WR. “Ocular manifestations of acquired immune deficiency syndrome”. Ophthalmology 96 (1989): 1092.
  3. Holland GN., et al. “Acquired immune deficiency syndrome, ocular manifestations”. Ophthalmology 90 (1993): 859.
  4. Sophia Pathai., et al. “Cytomegalovirus retinitis associated with HIV in resource-constrained settings: systematic screening and case detection”. International Health2 (2012): 86-94.
  5. Crowe SM., et al. “Predictive value of CD4+ lymphocyte numbers for the development of opportunistic infections and malignancies in HIV infected persons”. Journal of Acquired Immune Deficiency Syndromes 4 (1991): 770.
  6. Feroze KB and Gulick PG. “HIV Retinopathy”. [Updated 2022 Jul 19]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; (2022).
  7. Kumar P., et al. “CD4 counts: a strong indicator of retinal and ocular lesions in HIV disease”. Medical Journal Armed Forces India4 (2011): 354-357.
  8. Wren SM., et al. “Cytomegalovirus Retinitis in infancy”. Eye (Lond.) 18 (2004): 389-392.
  9. Biswas J., et al. “Ophthalmic manifestations of human immunodeficiency virus (HIV) infection in India”. Indian Journal of Ophthalmology 47 (1999): 87-93.
  10. Kupperman BD., et al. “Cross sectional prevalence of CMV retinitis in AIDS patients. Correlation with CD4 counts”. Investigative Ophthalmology and Visual Science 33 (1992): 750.

Citation

Citation: , Sameer I., et al. “Retinal Manifestations in Acquired Immuno Deficiency Syndrome: A Clinical Study and their Relationship to CD4 Cell Count".Acta Scientific Ophthalmology 5.12 (2022): 11-16.

Copyright

Copyright: © 2022 , Sameer I., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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