AIDS retinopathy is a non-infectious eye disorder that manifests in HIV positive persons when the normal blood flow to the retina is interfered with. It is the most common ocular manifestation of HIV, affecting about 50% of the population of people living with HIV. The disease is non-progressive and does not threaten vision.
The human immunodeficiency virus (HIV) affects all organs of the body, including the eyes. In HIV retinopathy, the viral infection involves the posterior segment of the eye, and more specifically, the retina. The retina is the lining located at the back of the eyes which senses the light that comes through the lenses. This part of the eye carries small blood vessels. Usually, the disorder comes about when the blood vessels directed to the retina are damaged or when there is an abnormal blood vessel growth.
With proper adherence to the anti-retroviral therapy (ART), chances of contracting retinopathy are very much limited. However, those with low immunity resulting from defaulted treatment or otherwise, are at a higher risk. Although the disorder will rarely result in vision loss, it could be the reason for other visual dysfunctions.
Also Known As
- HIV retinopathy
- HIV retinal vascular disease
- HIV microvasculopathy
Causes and Risk Factors
The etiology of the disease is not well established. It is said to develop due to either of the following:
- Immune complexes
- Direct infection of the retina by the virus
- Increased plasma viscosity
Persons with advanced HIV disease due to low immune systems face a higher risk of the disorder. It is seen in about 70% of those in the advanced stages of HIV, in 40% of those in the symptomatic intermediate stage and only in about 1% of those with asymptomatic HIV infection.
Signs & Symptoms
HIV microvasculopathy is characterized by:
- Cotton wool spots - They occur in about 50 to 60% of those with advanced HIV disease. The spots differ from those of infectious rhinitis by their relatively small size, non-progressive nature, superficial location and feathered edges.
- Retinal hemorrhages due to broken blood vessels
- Microvascular changes such as telangiectasia and microaneurysms
Serological tests can be conducted for HIV detection. On the other hand, fundoscopic examinations can be performed for diagnosis of retinopathy. These tests can include:
- Stereoscopic photography
- Direct visualization of the fundus
- Dilated fundoscopy
Usually, the symptoms resolve on their own without any specific treatments. Patients are however advised to adhere to their HIV drug therapy to boost their immunity.
In some cases, patients may be given Anti-vascular endothelial growth factor (Anti-VEGF) drugs. They work to inhibit abnormal growth of the retinal blood vessels.
The disease does not threaten the individual’s vision nor life. Later on however, it may be responsible for visual defects.
HIV positive persons should adhere to their medication to prevent retinopathy as well as other eye disorders. Regular check ups are also recommendable for diagnosis of serious visions threatening diseases that may arise from the disorder.