Abstract

STUDY OF RETINAL NERVE FIBER LAYER THICKNESS IN HIV POSITIVE PATIENTS

Author(s): Vishrutha sushekar1, Viswanath B.N1, Shashidhar1, Ravi1, Sandhya1, Rashmi H G1, Nagarathna1, Pooja Parthasathi1

BACKGROUND
Human Immune Deficiency Virus (HIV) infection continues to be major public health problem in United States with 56,000 new HIV infections per year. Worldwide the HIV pandemic continues with 33 million infected people and an annual infection rate of 2.7 million with 2 million deaths. Survival rate in HIV is increased due to Highly Active Combination Anti-Retroviral Therapy(HAART) The main pathological change causing optic changes are Retinal Nerve Fiber Layer (RNFL) thickness with secondary papillary changes and few other changes such as cotton wool spots, cytomegalovirus retinitis, abnormalities in visual function, decrease contrast sensitivity, color vision changes and visual field loss. These changes can be mediated by HIV associated neuro retinal disorder (HIV-NRD) which is characterized by changes in RNFL. RNFL thinning increase with time and decrease in CD4 count. If early diagnosed and started on treatment the decrease in vision can be prevented. Some studies have shown RNFL thinning in HIV infections correlates with more driving errors. So if early diagnosed it can help in selecting career options of young patients.
METHODS
It is a cross sectional study conducted from November 2019 to May 2021, where detailed ocular examination of HIV positive patients on HAART were done. Per papillary RNFL thickness measured using SD OCT in HIV positive patients and was analyzed.
RESULTS
The study included 100 HIV positive patients on HAART showed significant RNFL thinning in temporal quadrant of optic disc.
CONCLUSION
The study concluded that HIV is associated with per papillary retinal nerve fiber layer thinning without having any other ocular manifestations.