Scanning laser polarimetry demonstration of retinal nerve fiber layer damage in human immunodeficiency virus-positive patients without infectious retinitis.

Abstract

To use scanning laser polarimetry with variable corneal compensation to measure the retinal nerve fiber layer (RNFL) in human immunodeficiency virus (HIV)-infected patients. Three groups were analyzed in a prospective cohort study from one center. Group A consisted of 52 eyes of HIV-positive patients whose CD4 cell counts had never fallen below 100/mm (1.0 x 10/L). Group B included 60 eyes of HIV-positive patients with CD4 cell counts that had fallen below 100/mm for at least 6 months in their history. Group C consisted of 50 eyes of HIV-negative patients. None of the eyes had a history of infectious retinitis. Retinal birefringence imaging studies were performed using a commercially available scanning laser. Superior, inferior, and ellipse averages as well as nerve fiber indicator parameters were used for comparison. Group B significantly differed from group C in all parameters. Group B also differed from group A in all parameters with the exception of superior average. No difference was detected between group A and group C. Scanning laser polarimetry demonstrated RNFL thinning in HIV-positive patients without retinitis who had a history of low CD4 cell counts compared with HIV-positive subjects with high CD4 cell counts and HIV-negative patients.