Retinal nerve fiber layer evaluation in human immunodeficiency virus-positive patients

PURPOSE: To determine the effect of human immunodeficiency virus (HIV) infe ction on topographic measures of the optic disk and the retinal nerve fiber layer. METHODS: A cross-sectional study at the Acquired Immunodeficiency Syndrome (AIDS) Ocular Research Unit at the University of California, San Diego. Ret inal nerve fiber layer thickness at the optic nerve head was evaluated usin g the Heidelberg Retinal Tomograph, a confocal scanning laser tomograph in 38 HIV-positive and 24 age-matched HIV-negative subjects. RESULTS: HIV-positive patients without CMV retinitis showed significant dif ferences from HIV-negative normal controls in a number of measures of the r etinal nerve fiber layer. This indicated a loss of retinal ganglion cells i n HIV-positive patients without retinitis. HIV-positive patients with CMV r etinitis were worse in most measurements than both HIV-negative controls an d HIV-positive patients without CMV. CONCLUSIONS: Significant thinning of the retinal nerve fiber layer occurs i n HIV-positive patients without infectious retinopathy, and there are furth er changes in the optic disk associated with CMV retinitis. Confocal scanni ng laser tomography may be of use in the diagnosis of early HIV-associated visual function loss. (Am J Ophthalmol 2001;131:216-222. (C) 2001 by Elsevi er Science Inc. All rights reserved).