ELECTRORETINOGRAPHIC AND PSYCHOPHYSICAL FINDINGS DURING EARLY AND LATE STAGES OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND CYTOMEGALOVIRUSRETINITIS

Purpose: The authors examined electrophysiologic and psychophysical me asures of retinal function in patients infected with human immunodefic iency virus (HIV) at different stages of infection, including patients with cytomegalovirus retinitis (CMVR). Methods: All patients had comp lete ophthalmologic examinations. Rod-mediated psychophysical threshol ds were measured using a modified two-color dark-adapted perimetry tec hnique. Rod-dominated full field flash electroretinograms (ERGs) were obtained as a function of flash intensity, followed by cone-dominated ERGs. The 26 patients infected with HIV (26 eyes) were categorized int o three groups. Six patients were infected with HIV but had not progre ssed to acquired immunodeficiency syndrome (AIDS), and 14 had AIDS. Si x patients had CMVR with less than 10% of the retina involved. The dat a were compared with results from age-similar control subjects. Result s: Psychophysical thresholds as a function of retinal eccentricity wer e elevated for each of the three stages of HIV infection. The group of patients with CMVR had the greatest amount of threshold elevation and threshold elevation increased with retinal eccentricity. In addition, all three patient groups had abnormal electroretinographic findings. Patients with CMVR were affected more severely on all measures than we re the other HIV-infected groups. Conclusions: Results reveal that a d iffuse functional retinal pathology exists in eyes with the funduscopi c appearance of localized peripheral CMVR. Additionally, patients infe cted with HIV, including those without cotton wool spots, may have abn ormal retinal function.