Optical coherence tomography and multifocal electroretinogram study in human immunodeficiency virus-positive children without infectious retinitis

Background: The aim was to evaluate the macular structure and function in children with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis or visual symptoms. Methods: Thirty-eight eyes of 19 HIV-positive children (Group A) were examined. Group B included 20 (40 eyes) age- and sex-matched control subjects. Each individual underwent a complete ophthalmic examination, optical coherence tomography (OCT) scan and multifocal electroretinogram (mfERG) recording. Results: In all patients, visual acuity and colour vision testing were normal. The mean foveal thickness in groups A and B was 190.28 +/- 26.58 (SD) mu m and 169.47 +/- 10.17 mu m, respectively (p = 0.0002). In Group A, the mean retinal response density of the fovea (area 1) was 19.87 +/- 10.16-nV/deg(2) and the latency was 38.56 +/- 1.18-ms. In the parafoveal area (area 2), the mean retinal response density was 10.82 +/- 2.34-nV/deg(2) and the mean latency was 36.52 +/- 1.73-ms. In the perifoveal area (area 3), the mean retinal response density was 10.83 +/- 0.90-nV/deg(2) and the mean latency was 36.36 +/- 1.90-ms. In Group B, the mean retinal response density of area 1 was 22.02 +/- 0.9-nV/deg(2) and the mean latency was 32.56 +/- 1.25-ms. In area 2, the mean retinal response density was 12.23 +/- 0.55-nV/deg(2) and the mean latency was 30.84 +/- 1.22-ms. Finally, in the perifoveal area (area 3), the mean retinal response density was 12.74 +/- 0.44-nV/deg(2) and the mean latency was 29.7 +/- 11.09-ms. The differences in amplitude and latency were statistically significant. Conclusion: Increased foveal thickening and significant decrease of the electrical activity of areas 1, 2 and 3 were found in HIV-positive children. These findings suggested some subclinical dysfunction of the photoreceptors and the inner retinal layers of the fovea in HIV-positive children with normal vision and without ocular disease.