IMPAIRMENT OF COLOR CONTRAST SENSITIVITY AND NEURORETINAL DYSFUNCTIONIN PATIENTS WITH SYMPTOMATIC HIV-INFECTION OR AIDS

Ophthalmic and neurological complications are frequent findings in pat ients with AIDS. Little is known about neuroretinal dysfunction in pat ients with HIV infection. The purpose of this study was to measure and evaluate colour vision in patients with HIV infection or AIDS. Colour contrast sensitivity tests were performed on 75 patients (150 eyes) i n different stages of HIV infection. A highly sensitive computer graph ics system was used to measure tritan, deutan, and protan colour contr ast thresholds. Patients were classified into three clinical groups: ( a) asymptomatic HIV infection, (b) lymphadenopathy syndrome or AIDS-re lated complex, and (c) AIDS. Overall, tritan (p<0.0001), deutan (p=0.0 03), and protan (p=0.009) colour contrast sensitivities were significa ntly impaired in patients with HIV infection compared with normal cont rols. Colour thresholds in patients with asymptomatic HIV infection (m ean tritan threshold: 4.33; deutan: 4.41; protan: 3.97) were not impai red compared with normal controls. Colour vision was slightly impaired in patients with lymphadenopathy syndrome or AIDS-related complex (tr itan: 6.25 (p<0.0001); deutan: 4.99 (p=0.02); protan: 4.45 (p=0.05)). In patients with AIDS the impairment was even more marked (tritan: 7.6 6 (p<0.0001); deutan: 5.15 (p<0.0009); protan: 4-63 (p=0.004)). Analys is of covariance controlling for age demonstrated a close association between impairment of tritan colour contrast sensitivity and progressi on of HIV disease (p<0.0001). Following Kollner's rule, our study sugg ests that neuroretinal dysfunction occurs in patients with symptomatic HIV infection or AIDS. This is emphasised by the finding that the rel ative impairment in tritan vision compared with deutan/protan vision m ight reflect the difference in the number of cones or receptive fields . Measurement of tritan colour contrast sensitivity appears to be an a ppropriate and easily applicable method to detect early neuroretinal d ysfunction in patients with HIV disease.