[Follow-up of HIV infected patients with reduced pattern ERG]

We have recently reported a reduction of pattern electroretinogram (p-ERG) in patients with HIV infection. Amplitudes were reduced in HIV-infected patients with microangiopathy, but also in some cases with normal fundus. These findings suggested the existence of diffuse defects in ganglionic cell activity in HIV-infected patients. We have now started a prospective follow-up study in order to pursue the development of (a) p-ERG amplitudes and (b) funduscopic changes and visual acuity in these patients. In patients with normal fundus or microangiopathy who did not develop cytomegalovirus (CMV) retinitis, no significant tendency for the p-ERG amplitudes to fall could be demonstrated during the observation period of 1-16 (mean: 7) months. With the appearance of retinitis, the p-ERG amplitude decayed. In some cases, a pathologic p-ERG was recorded before retinitis appeared: 3 of 12 patients with p-ERG amplitudes in the pathological range later developed CMV retinitis and only 1 of 21 patients with normal p-ERG later developed retinitis. In some patients with AIDS or related disorders, p-ERG may be a useful additional diagnostic tool.