Visual Field Loss in HIV-Positive Patients of Non-Infectious HIV Retinopathy

This study was terminated December 11, 2019.

Background:

Diminished visual acuity is a common problem among patients with HIV infection and can greatly impact their quality of life. HIV retinopathy occurs as a result of ocular changes in the fundi, typically characterized by cotton wool spots. The risk of this problem among HIV patients in India now that HIV treatment is more widely available is unclear. HIV retinopathy is diagnosed by computerized achromatic automated perimetry and short wavelength automated perimetry. In this study, we will assess HIV-positive patients for cotton-wool spots, and we will document prevalence of visual field loss due to HIV retinopathy.

The clinical spectrum of inflammation in adult noninfective HIV retinopathy patient is vitritis, papillitis, macular edema and epiretinal membrane. Noninfectious HIV retinopathy patients are treated with antiretroviral therapy, but relapse occurs. This may be due to the failing immune system and inability to eliminate the virus completely. Early detection of visual field defects can help with early intervention, thereby slowing the rate of deterioration.  

Main Objectives:

1. To determine the prevalence of visual field loss among HIV-positive patients who have HIV retinopathy. 
2. To study peripheral visual field loss as it relates to HIV retinopathies.
3. To understand the progression of visual field loss during HIV treatment. 

Study Design

This case control study will be conducted at the Ophthalmic OPD at BJGMC and Sassoon General Hospital in Pune, India. The study arm will involve HIV-positive adults who are diagnosed with noninfectious HIV, and the control arm will involve non-HIV-infected patients. The study arm will enroll HIV-positive patients whose ophthalmoscopic examination and fundus imaging reveals no retinopathy, but who have ocular changes in fundi characterized by cotton wool spots and intra-retinal hemorrhages.