Ocular manifestations of HIV and AIDS patients on antiretroviral therapy in a tertiary hospital in South Africa

Abstract

Background: Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) causes impairment to the immune system, which then leads to immunocompromised conditions, and allows for opportunistic infection to invade many organs of the human body. Ocular involvement is very common; the various ocular complications may be asymptomatic and they may be the initial manifestations of the underlying diseases.

Aim: This study aimed to determine the prevalence and the type of ocular manifestations that occur in HIV and AIDS patients.

Setting: The study was conducted on ART (antiretroviral treatment) clinic patients in the Department of Ophthalmology at the Steve Biko Academic Hospital, Pretoria.

Methods: This descriptive, cross-sectional study was conducted on HIV and AIDS patients referred from the ART clinic for complete ophthalmological evaluation, irrespective of the immune system status and presence or absence of symptoms. All the participants underwent an ophthalmologic evaluation, which included case history and ocular examinations of both anterior and posterior segments.

Results: Out of the 177 participants, 72.3% had visual acuity of between 6/3 to 6/18, 10% had poor vision, 7% had lost one eye to ocular complications and 5% were blind. The most common anterior segment manifestations were uveitis and dry eye, whilst HIV-related retinopathy and papilledema were the most prevalent conditions in the posterior segment. Only three participants had third cranial nerve palsy.

Conclusion: The prevalence of ocular manifestations was significantly higher with lower CD4+ cell counts, which could be regarded as predictors for the occurrence of ocular morbidity in HIV and AIDS patients.