Non-infectious ocular surface abnormalities in AIDS patients.

Purpose AIDS patients more nad more complain from conjunctival symptoms related to dry eyes and conjunctivitis, but little is known about ocular surface abnor malities in these patients. We used impression cytology (IC) and tear IgE t o assess inflammatory status of the ocular surface in AIDS. Methods IC were taken in 30 patients infected by HIV (including 28 AIDS patients). After collecting general clinical information, and CD4 rate, we made a comp lete ophthalmological examination (Schirmer test, BUT, Lissamine green and tear IgE). IC were processed by an immunofluorescence technique with antibo dies to HLA DR : an inflammatory marker normally restricted to conjunctival dendritic cells ; and to APO 2.7 an apoptotic cell marker. Results Seventy per cent suffered from subjective and/or objective signs, and BUT w as abnormal in 70% of patients. Tear IgE was increased in 36% of the eyes, even without known allergy. A decrease in density of dendritic cells and an abnormal expression of HLA DR antigens by epithelial cells were common fea tures in both groups (respectively 90% and 80% of the eyes). An increase of the APO 2.7 marker was significantly found in 70% of eyes. We found no cor relation between clinical abnormalities and DR antigen overexpression. Tear IgE were related to HLA DR expression. Conclusion This work shows that even when AIDS patients are asymptomatic they may pres ent significant alterations of the ocular surface probably due to their imm unological disorders.