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Pattern, flicker, and flash electroretinography in human immunodeficiency virus infection: a longitudinal study
M M Gellrich1, G Kade, J Gerling
1Universitäts-Augenklinik, Freiburg, Germany.
German Journal of Ophthalmology
|January 1, 1996
Summary
Human immunodeficiency virus (HIV) causes progressive vision loss in retinal neurons, even without visible retinopathy. Electroretinography reveals significant declines in rod, cone, bipolar, and ganglion cell function over time.
Area of Science:
- Ophthalmology
- Neuroscience
- Infectious Diseases
Background:
- Human immunodeficiency virus (HIV) infection can affect the visual system.
- Retinal involvement in HIV is not fully understood, particularly subclinical changes.
- Visible HIV retinopathy does not fully explain retinal damage.
Purpose of the Study:
- To investigate electroretinographic (ERG) changes in the course of HIV disease.
- To assess functional impairment in different retinal neurons in HIV-infected individuals without retinitis.
Main Methods:
- Longitudinal study of 42 eyes from HIV-infected individuals without retinitis.
- Serial electroretinography (ERG) examinations over a mean observation period of 9.6 months.
- Analysis of pattern-ERG, flicker-ERG, a-wave, and b-wave amplitudes.
Main Results:
- No significant change in visual acuity was observed.
- Progressive functional impairment was detected across visual pathway neurons.
- Pattern-ERG (ganglion cells) decreased by 11% (P < 0.02).
- B-wave (bipolar cells) decreased by 13% (P < 0.02).
- A-wave (rods) diminished by 21% (P < 0.02).
- Flicker-ERG (cones) decreased by 20% (P < 0.02).
Conclusions:
- HIV infection leads to significant, progressive functional decline in retinal neurons.
- Subclinical retinal damage occurs in HIV, not solely explained by visible retinopathy.
- ERG is a valuable tool for detecting early visual pathway dysfunction in HIV disease.