White-noise field campimetry in patients with HIV infection

Purpose: The first morphological changes in eyes with HIV infection are mic rovascular disease of the retina with cotton-wool spots and microaneurysms. The study was performed to find out if evidence of disturbances of ocular microcirculation can be established by non-invasive methods. Patients and methods: Twenty-seven patients with HIV infection and without opportunistic infections underwent thorough ophthalmologic examination with threshold-oriented, suprathreshold perimetry (TAP 2000 ct, Oculus) and whi te-noise field campimetry (TEC, Oculus). Results:Visual field examination was normal in 23 out of 27 patients (85%), whereas 4 patients showed relative field defects in at least one eye. In w hite-noise field campimetry 13 out of 23 perimetrically unaffected patients (56%) perceived scotomas in one or both eyes. These scotomas were not stab le. Three of 4 patients with relative scotomas in the Visual field had cott on-wool spots in the retina and showed a stable scotoma in campimetry. Visu al acuity, IOP, and cup/disc ratio were within normal ranges. Conclusion: White-noise field campimetry complements the standard examinati on of patients with HIV and might be capable of indicating disturbances of ocular microcirculation by a non-invasive method before morphological chang es in the retina can be seen.