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The Official Scientific Journal of Delhi Ophthalmological Society
Evaluation of Fundoscopic Findings in HIV Positive Patients in Relation to HAART and CD4 Count
Ajit Kamalakar Joshi, Natasha Patel, Krishangee Kalita
Department of Ophthalmology, Bharati Vidyapeeth Medical College & Hospital, Sangli, Maharashtra, India
Corresponding Author:
Krishangee Kalita 
MS
Department of Ophthalmology
Bharati Vidyapeeth Medical College & Hospital, Sangli, Maharashtra, India
Email id: drkrishangeekalita@gmail.com
Published Online: 01-NOV-2018
DOI: http://dx.doi.org/10.7869/djo.394
Abstract
Aim: To evaluate the fundus findings in patients with HIV in correlation to highly active antiretroviral therapy (HAART) and CD4 count.
Materials and Methods: It was a hospital based observational study. It was conducted from December 2014 to September 2016 in the Ophthalmology Department, Bharati Hospital, Sangli. A total of 195 registered HIV patients on HAART were selected for the study. Informed  written consent of the subjects to participate in the study was taken. Patients of both sexes of any age group were included. Patients who did not give consent for the study were excluded.
Result: The mean age of study subjects was 40.49 years. 83.6% subjects had a best corrected visual acuity (BCVA) between 6/6 to 6/9 in the right eye, 82.6% had BCVA between 6/6 to 6/9 in the left eye. Visual acuity was below 6/60 in 5.1% subjects. The most common anterior segment pathology was cataract (8.2%), corneal opacity (2.1%), pterygium (2.1%) and pseudophakia. CD4 count above 500 cells/mm3 was seen in 28.7% cases while below 250 cells/mm3 was seen in 29.3% cases. The mean age of study subjects was 40.49 years with 51.8% between 21-40 years. Female predominance was observed in study group with 57.9% females to 42.1% males. The prevalence of ophthalmic manifestations in HIV patients on HAART was observed as 37.9%. Prevalance of posterior segment manifestations was 19.5%. Prevalance of ophthalmic pathology increased as CD4 count decreased (250 cells/mm3).
Conclusion: In the present study, significant posterior segment manifestations were seen in HIV positive patients on HAART. Low CD4 count is a risk as well as predictor for ocular manifestations. Advent of HAART has reduced the prevalence of ocular manifestations. Routine referral system for ocular evaluation from other medical departments is mandatory for timely diagnosis of the vision threatening conditions. It is therefore recommended that eye care should be a part of medical care in the management of patients on HAART.
Keywords : HIV retinopathy, HAART, CMV retinitis, Immune recovery uveitis
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