PATTERN ELECTRORETINOGRAMS AND VISUAL-EVOKED POTENTIALS IN HIV-INFECTION - EVIDENCE OF ASYMPTOMATIC RETINAL AND POSTRETINAL IMPAIRMENT IN THE ABSENCE OF INFECTIOUS RETINOPATHY
Vj. Iragui et al., PATTERN ELECTRORETINOGRAMS AND VISUAL-EVOKED POTENTIALS IN HIV-INFECTION - EVIDENCE OF ASYMPTOMATIC RETINAL AND POSTRETINAL IMPAIRMENT IN THE ABSENCE OF INFECTIOUS RETINOPATHY, Neurology, 47(6), 1996, pp. 1452-1456
Retinal microangiopathy associated with HN infection is usually asympt
omatic and escapes detection unless funduscopic examination is perform
ed when evanescent cotton-wool spots are present. The aim of this stud
y was to assess retinal and optic nerve/retrochiasmal function in HIV
infection by means of electrophysiologic techniques that are sensitive
to the detection of subclinical visual impairment. We studied transie
nt and steady state pattern electroretinograms (PERGs) and pattern-rev
ersal visual evoked potentials (PVEPs) in 21 HIV-negative controls and
33 HIV-positive subjects (16 with CD4 greater than or equal to 200/mL
and 17 with CD4 < 200/mL) without visual symptoms or infectious retin
opathy. HIV-positive subjects with CD4 greater than or equal to 200/mL
had reduced amplitude of the transient PERG P1 potential, but no othe
r latency or amplitude abnormalities. The HIV-positive group with CD4
< 200/mL had reduced P1 transient PERG amplitude, as well as latency d
elay of the transient PVEP. These findings suggest that HIV infection
is associated with subclinical retinopathy and that, when severe immun
osuppression occurs, both retinopathy and optic nerve/retrochiasmal dy
sfunction are present. Transient PERGs are more sensitive measures of
visual system disease in HIV infection than are steady state responses
.