Ocular Manifestations in Patients Infected with Human Immunodeficiency Virus

Purpose: Up to 70% of patients with acquired immunodeficiency syndrome (AIDS) have AIDS-related ocular involvements which may severely affect their quality of life caused by visual impairment. This study was designed to investigate the ocular manifestations in patients infected with human immunodeficiency virus (HIV). Methods: In this case series study, 41 HIV positive patients were investigated through the first 6 months of 2003, in Farabi eye hospital, in Tehran, Iran. They were all under highly active antiretroviral therapy (HAART), but none was taking rifabutin, protease inhibitors or cidofovir. Complete ocular examination was carried out for each by Slit-lamp biomicroscope and indirect ophthalmoscope after pupil dilation. Results: Thirty seven percent of patients had ocular disorders. 93% were male, 40% of all patients were 30-40 years old, 93.3% were in HIV stage (not AIDS stage). Intravenous drug (IVD) pathway had infected 86.6% of the patients, and 46.6% (n=19) had been infected throughout the previous three years. The most common ocular involvements among HIV positive patients were cotton wool spots (CWS) and vitritis (12.2%), which includes 66.6% of ophthalmic symptoms. Conclusion: A variety of ophthalmic symptoms might affect HIV positive patients. These symptoms may cause severe disability in their lives, so ophthalmologists should pay more attention to HIV patients with ocular manifestations. Further studies are required for a better understanding of risk factors or possible human genes involved in occurrence of ocular involvement in HIV patients.