Optical coherence tomography and multifocal electroretinogram study in human immunodeficiency virus-positive children without infectious retinitis.

Background: The aim was to evaluate the macular structure and function in children with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis or visual symptoms.

Methods: Thirty-eight eyes of 19 HIV-positive children (Group A) were examined. Group B included 20 (40 eyes) age- and sex-matched control subjects. Each individual underwent a complete ophthalmic examination, optical coherence tomography (OCT) scan and multifocal electroretinogram (mfERG) recording.

Results: In all patients, visual acuity and colour vision testing were normal. The mean foveal thickness in groups A and B was 190.28 ± 26.58 (SD) µm and 169.47 ± 10.17 µm, respectively (p = 0.0002). In Group A, the mean retinal response density of the fovea (area 1) was 19.87 ± 10.16 nV/deg(2) and the latency was 38.56 ± 1.18 ms. In the parafoveal area (area 2), the mean retinal response density was 10.82 ± 2.34 nV/deg(2) and the mean latency was 36.52 ± 1.73 ms. In the perifoveal area (area 3), the mean retinal response density was 10.83 ± 0.90 nV/deg(2) and the mean latency was 36.36 ± 1.90 ms. In Group B, the mean retinal response density of area 1 was 22.02 ± 0.9 nV/deg(2) and the mean latency was 32.56 ± 1.25 ms. In area 2, the mean retinal response density was 12.23 ± 0.55 nV/deg(2) and the mean latency was 30.84 ± 1.22 ms. Finally, in the perifoveal area (area 3), the mean retinal response density was 12.74 ± 0.44 nV/deg(2) and the mean latency was 29.7 ± 11.09 ms. The differences in amplitude and latency were statistically significant.

Conclusion:   Increased foveal thickening and significant decrease of the electrical activity of areas 1, 2 and 3 were found in HIV-positive children. These findings suggested some subclinical dysfunction of the photoreceptors and the inner retinal layers of the fovea in HIV-positive children with normal vision and without ocular disease.