Visual changes in human immuno-deficiency virus infection.

Background: Many Human Immuno-Deficiency Virus (HIV) patients develop ocular involvement during the course of the disease, including HIV retinopathy and cytomegalovirus (CMV) retinitis. It is well established that contrast sensitivity and color vision may be affected in other retinal diseases, such as diabetes, before obvious signs and symptoms. We therefore examined patients with early HIV disease for visual involvement.

Methods: Subjects consisted of 19 HIV-positive patients and 15 controls. None of the HIV-positive patients showed any signs of HIV retinopathy. High and low contrast visual acuity, luminance contrast sensitivity (CS), short wavelength cone (S-cone) CS, and color vision were assessed in the right eye of each subject.

Results: S-cone CS was significantly reduced in the HIV-positive group (HIV mean = 0.91 +/- 0.15 log CS; normal mean = 1.10 +/- 0.09 log CS, t = 4.19, p < 0.001). Consistent with this finding, four of the HIV-positive patients demonstrated tritanopic D-15 results. High and low contrast visual acuity and CS were not significantly different in the HIV-positive and control groups.

Conclusion: These findings indicate that HIV-positive patients can have S-cone/tritanopic abnormalities despite normal appearing fundi and that there may be damage to the visual system early in HIV infection.