HIV-RELATED OCULAR MICROANGIOPATHIC SYNDROME AND COLOR CONTRAST SENSITIVITY

Purpose. Color vision deficits in patients with acquired immunodeficie ncy syndrome (AIDS) or human immunodeficiency virus (HIV) disease were reported, and a retinal pathogenic mechanism was proposed. The purpos e of this study was tp evaluate the association of color vision defici ts with HIV-related retinal microangiopathy. Methods. A computer graph ics system was used to measure protan, deutan, and tritan color contra st sensitivity (CCS) thresholds in 60 HIV-infected patients. Retinal m icroangiopathy was measured by Counting the number of cotton-wool spot s, and conjunctival blood-flow sludging was determined. Additional pre dictors were CD4+ count, age, time on aerosolized pentamidine, time on zidovudine, and Waiter Reed staging. The relative influence of each p redictor was calculated by stepwise multiple regression analysis (incl usion criterion; incremental P value = < 0.05) using data for the righ t eyes (RE). The results were validated by using data for the left eye s (LE) and both eyes (BE). Results. The only included predictors in mu ltiple regression analyses for the RE were number of cotton-wool spots (tritan: R = .70; deutan: R = .46; and protan: R = .58; P < .0001 for all axes) and age (tritan: increment of R [R(i)] = .05, P = .002; deu tan: R(i) = .10; P = .004; and protan: R(i) = .05, P = .002). The pred ictors time on zidovudine (R(i) = .05, P = :002) and Waiter Reed stagi ng (R(i) = .03, P = .01) were additionally included in multiple regres sion analysis for tritan LE. The;results for deutan LE were comparable to those for the RE. In the analysis for protan LE, the only included predictor was number of cotton-wool spots. In the analyses for BE, no further predictors were included. The predictors Walter Reed staging and CD4+ count showed a significant association with all three criteri a in univariate analysis. Additionally, tritan CCS was significantly a ssociated with conjunctival blood-flow sludging. Conclusion. CCS defic its in patients with HIV disease are primarily associated with the num ber of cotton-wool spots. Results of this Study are in accordance with the hypothesis that CCS deficits are in a relevant part caused by neu roretinal damage secondary to HIV-related microangiopathy.