One Year Cross-Sectional Study of Ocular Manifestations in HIV-Positive/AIDS Patients Evaluated at KLE’S Dr. Prabhakar Kore Hospital and MRC, Belgaum

Abstract

Background: Acquired Immuno-Deficiency Syndrome is a multisystem disorder which affects almost all organs. The prevalence of ocular manifestations of HIV/AIDS is 50%-75%. Although studies to record prevalence of ocular manifestations have been done in other countries, less data is available from India and their correlation with the CD4+ T cell count has not been studied adequately. Objective: To estimate the prevalence of ocular manifestations in a group of patients with HIV/AIDS with the secondary objective to find the correlation of ocular findings with CD4+T cell count. Method: A cross sectional ophthalmic evaluation of HIV positive patients attending the outpatient clinic or admitted in the inpatient department having done their CD4+T cell counts. Results: 100 patients were enrolled in this study. There were 76 men ( Mean Age-40.48year ) , and 24 women. ( Mean age -37.66years) . 51( 51% ) patients had normal eye examination. The finding in the other 49 ( 49% ) patients are HIV retinopathy in 22 ( 22% ) patients, Papilledema in 7( 7% ) patients, Dry eyes in 6 ( 6% ) patients , CMV retinitis in 4( 4% ) patients, choroidal tubercles in 3( 3% ) , Cranial nerve palsy in 3 ( 3% ) patients and other findings being less common. Posterior segment findings were more common than the anterior segment manifestations. Visual acuity was 6/18 in the better eye in 83( 93.2% ) of patients.2 ( 2% ) patients had vision of <3/60 in both eyes and 11 patients were too ill to co-operate fully with the examination. Respiratory System was the most commonly involved organ, i.e in 40( 40% ) patients with 23( 23% ) patients having tuberculosis. V 44 ( 54.3% ) patients belonging to stage 3 & 4 WHO clinical staging for HIV had abnormal eye findings in comparison with the 5 ( 26 % ) patients belonging to WHO clinical stage 1&2 and the association being statistically significant ( p<0.1 ) .We found no correlation between CD4+T cell count and the ocular manifestations of HIV/AIDS. Conclusion: The study concludes that AIDS affects the eyes of significant proportion of the patients. The spectrum of ocular lesions associated with HIV infection in this region is different from that seen elsewhere in the world. The prevalence of CMV retinitis is lower than other studies. Majority of the patients have no ocular complaints. Screening for ocular complaints is not a reliable method to identify those with the ocular morbidity. Comprehensive ophthalmic examination of all HIV infected patients with AIDS at regular intervals will help in identifying ocular morbidity early.