Dr. Shruti Prakash Naik,
ABSTRACT BACKGROUND Ocular involvement in HIV/AIDS includes various clinical presentations including both anterior and posterior segment, most of the manifestations are those of the posterior segment. The severity of these posterior segment changes increases with decreased CD4 count. Aim of the study is to look for severity of ocular manifestations in correlation with CD4 count. MATERIALS AND METHODS A cross sectional study of ocular changes in 360 cases of HIV/AIDS patients between October 2016-May 2018. All patients underwent thorough ophthalmic evaluation including BCVA, Anterior segment examination with slit lamp biomicroscopy and posterior segment examination with Indirect ophthalmoscopy, CD4 count was noted and patients were categorised based on CD4 count and correlation of severity of ocular manifestations with CD4 count done with statistical software SPSS. RESULTS Out of 360 patients, 267 were on HAART. 54.4 % were males and 45.6% females. Maximum number of patients were in the age group of 31-40 years. Ocular manifestations were present in 252(70%) patients. Most common manifestation was HIV retinopathy (18.8%) followed by dry eye (6.9%), cataract (5.5%), CMV retinitis (5.2%), choroiditis (3.6%). CMV retinitis, choroiditis and orbital cellulitis were common in patients with CD4+count<50. Severity of ocular manifestations involving posterior segment and orbital cellulitis increased with decrease in CD4 count. There was statistically significant association between severity of ocular manifestations with CD4 count (P<0.001), and vision with CD4 count (P<0.001). CONCLUSION Patients with low CD4 count are at increased risk of acquiring severe manifestations such as posterior segment changes and orbital cellulitis. Complete ocular evaluation is must in all patients with HIV/AIDS for early diagnosis and treatment of sight threatening complications.
