Abstract:

Objective To investigate the characteristics of fundus lesions in patients with acquired immunodeficiency syndrome (AIDS) and their relationship with systemic concomitant diseases. Design Retrospective case series. Participants 343 AIDS patients admitted to Beijing Ditan Hospital from March 2015 to December 2016. Methods A total of 343 AIDS patients were examined by systemic and ophthalmic examination, including visual acuity, intraocular pressure, slit lamp, binocular indirect ophthalmoscope and fundus photography, and their clinical characteristics were observed. According to their fundus manifestations, they were divided into the following groups: cytomegalovirus retinitis (CMVR) group, human immunodeficiency virus (HIV) retinopathy group and control group. Main Outcome Measures Visual acuity, fundus, CD4+T cell count, peripheral blood HIV viral load. Results Among the 343 patients, 46 eyes showed CMVR and 74 eyes showed HIV retinopathy. More patients in the control group received HAART more than 6 months. CD4+T cell count was 53.86±101.14 /μl in the CMVR group, 33.69±47.06 /μl in the HIV retinopathy group, and 120.28±175.80 /μl in the control group. CD4+T cell count lower than 50 /μl was a risk factor for CMVR (P=0.000). Tuberculosis infection occurred in 65 cases, cryptococcal meningitis in 20 cases, and syphilis in 68 cases. A total of 39 eyes had visual acuity less than 0.3. Ophthalmic examination found optic disc edema in 19 eyes, optic nerve atrophy in 14 eyes, vitreous opacity in 28 eyes, cataract in 8 eyes, cured CMVR in 12 eyes, and retinal detachment in 12 eyes. Optic disc edema was associated with cryptococcal meningitis and syphilis infection (P=0.000). Optic nerve atrophy was associated with cryptococcal meningitis and cured CMVR lesions (P=0.000), and CMVR was associated with retinal detachment and vitreous opacity (P=0.000). Conclusion Low CD4+T cell count is a risk factor for CMVR. Ophthalmologist should pay attention to the fundus damage caused by accompanied diseases with AIDS.

Key words: acquired immune deficiency syndrome, cytomegalovirus retinitis, HIV retinopathy, CD4 + T cells, risk factors