Vitreoretinal manifestations of human immunodeficiency virus infection and acquired immunodeficiency syndrome in patients attending an antiretroviral therapy clinic in Nigeria: A cross sectional study

Abstract

Background: The human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a multi-systemic disease with known manifestations involving all ocular structures from the orbit and ocular adnexa, anterior segment to the retina and vitreous. Some of these manifestations including cytomegalovirus (CMV) retinitis and HIV retinopathy are HIV/AIDS-defining illnesses. The aim of this study is to determine the vitreoretinal manifestations in patients with HIV/AIDS attending an antiretroviral therapy clinic in Nigeria. Methods: This was a prospective, cross-sectional study of consenting, confirmed HIV/AIDS patients attending an antiretroviral therapy clinic in Nigeria. All willing, consecutive patients who gave an informed consent were recruited. Sociodemographic data and clinical information were collected with the use of a structured interviewer–administered questionnaire. Best-corrected visual acuity was recorded. Anterior segment and ocular adnexa examination was performed with a pen torch. Detailed anterior and posterior segment examination was performed with slit lamp biomicroscopy with Volks +78 diopter lens and binocular indirect ophthalmoscopy. The data were analyzed with SPSS (statistical package for social sciences) version 16. Ethical approval was obtained from the institutional ethics committee. Results: Three hundred and eighteen patients were studied of which 85 (26.7%) had disorders affecting the retina and vitreous. The female-to-male ratio was 2:1. More than a third of patients (38.7%) were in the 40–49 years of age group and the mean age was 47.2 years. The most common vitreoretinal lesion was presumed ocular toxoplasmosis present in 9.7% of all respondents. This was closely followed by HIV retinopathy in 3.5%, ocular tuberculosis in 1.8%, and CMV retinitis in 1.6% respondents. Two hundred and seventy-seven (87.1%) respondents were on highly active antiretroviral therapy and 41 (12.9%) were not on treatment. Conclusion: A high prevalence of ocular conditions especially those affecting the retina and vitreous exists in patients with HIV/AIDS attending the antiretroviral therapy clinic in a tertiary hospital in Nigeria. Regular eye examinations are recommended for these patients to prevent potentially visual debilitating disorders.