ANALYSIS OF VISUAL DYSFUNCTIONS IN HIV-POSITIVE PATIENTS WITHOUT RETINITIS

PURPOSE: To investigate visual dysfunctions in ophthalmoscopically nor mal human immunodeficiency virus (HIV) positive patients and to correl ate the results to the stage of HIV disease and neuropsychological sta tus. METHODS: Fifty-one randomly selected eyes (26 right, 25 left) of 51 HIV-positive patients with visual acuity measurements of 20/20 or b etter and no ophthalmoscopically detectable disorders were prospective ly examined using achromatic and short-wavelength automated perimetry, color vision testing, and contrast sensitivity testing, CD4(+) T-lymp hocyte count, presence of systemic infection, hemoglobin, hematocrit, serum beta(2)-microglobulin levels, and results of neuropsychological testing were also analyzed. RESULTS: On achromatic automated perimetry , 21.6% (11/51) of patients performed abnormally according to the mean defect and 27.5% (14/51) according to the Glaucoma Hemifield Test; 29 .4% (15/51) performed abnormally on short wavelength automated perimet ry according to the mean defect and 23.5% (12/51) according to the Gla ucoma Hemifield Test. On contrast sensitivity, 5.9% (3/51) of patients performed abnormally in the 1.5-cycles per degree (cpd) line, 2.0% b (2/51) in the 3-cpd line, 23.5% (12/51) in the 6-cpd line, 25.5% (13/5 1) in the 12-cpd line, and 33.3% (17/51) in the 18-cpd line. On the Fa rnsworth-Munsell 100 hue test, 29.4% (15/51) of patients performed abn ormally. After correction for multiple correlations, two statistically significant correlations were found: sum of log contrast sensitivity with achromatic automated perimetry and sum of log contrast sensitivit y with the Farnsworth-Munsell 100-hue test. CONCLUSIONS: A significant percentage of HIV-positive patients with visual acuity of 20/20 or be tter and no ophthalmologic evidence of retinitis performed abnormally on visual psychophysical tests. The severity of visual dysfunction was not correlated with the stage of HIV infection or the degree of neuro psychological dysfunction.