Abstract:
BACKGROUND : The prevalence of HIV and AIDS is causing an enormous public health burden.
Its manifestations spare no organ. Ocular complications are mainly attributed to various
opportunistic infections which are directly or indirectly caused by immune deficiency.
Purpose and aim: The purpose of this study was to determine the effect of HIV and AIDS on
subjective amplitude of accommodation of patients under treatment with antiretrovirals and
then to compare their results to those of control subjects.
METHODS : The study took place over a period of 10 months. A quantitative study was carried
out on 58 subjects (29 ± 5.5 years) with HIV and AIDS and 35 (28.67 ± 4.6 years) controls of
similar age. Amplitude of accommodation was measured using the subjective Royal Air Force
push-up method. The influence of CD4+ cell count was also recorded.
Results: People with HIV and AIDS had lower mean amplitude of accommodation (5.69 ± 0.88 D)
compared to controls (8.53 ± 1.2 D). The decrease in amplitude of accommodation did not show
any correlation with the CD4+ cell count. Lower amplitude of accommodation exists in people
living with HIV and AIDS when compared with age-related healthy people.
CONCLUSION : The results suggest that patients with HIV and AIDS on antiretroviral drugs
(ARVs) have reduced amplitude of accommodation and might experience presbyopia
earlier in life than participants without HIV and AIDS. The reduced amplitude of
accommodation could be the initial presentation of HIV infection before the systemic
manifestation. The possible causes could be the direct neuronal infection by HIV-1, ARVs
use, pathological changes of the lens and ciliary muscle or the sensory component of the
visual system. It is unknown whether the reduced amplitude of accommodation occurred
prior to antiretroviral therapy or represents an ongoing injury to the eye and visual system
by the HIV.
