Relationship between retinal nerve fiber layer and visual field function in human immunodeficiency virus-infected patients without retinitis.

PURPOSE: To evaluate the spatial association between visual field (VF) sensitivity loss and retinal nerve fiber layer (RNFL) thinning in patients infected by the human immunodeficiency virus. METHODS: Fifty-one eyes of 51 human immunodeficiency virus-infected patients and 22 eyes of 22 control subjects were enrolled. Patients were evaluated using the Fast RNFL scan strategy on Stratus OCT and the 24-2 full-threshold program on the Humphrey Matrix frequency doubling technology (FDT) perimeter. Associations between RNFL thickness and VF sensitivity were evaluated globally, in 12 clock-hour optical coherence tomography sectors and in 21 VF zones; linear and quadratic regression models were used in the statistical analysis. RESULTS: The linear and quadratic regression associations between the FDT Matrix pattern standard deviation and the average RNFL thickness in human immunodeficiency virus-infected patients were r2 = 0.185 and r2 = 0.218 (P < 0.05), respectively. The correlation between the FDT Matrix mean deviation and the average RNFL thickness was not significant (P > 0.05). Stronger associations were found when regional RNFL thinning was compared with locally measured FDT Matrix pattern deviation, especially between nasal RNFL measurements and temporal VF zones, and between superior RNFL measurements and inferior VF zones. CONCLUSION: Retinal nerve fiber layer thinning was related to VF sensitivity loss in human immunodeficiency virus-infected patients and regional associations between optical coherence tomography and FDT Matrix sectors were stronger than the associations between global measurements.

Fundus autofluorescence and spectral domain optical coherence tomography in recurrent serpiginous choroiditis: case report.

PURPOSE: To report fundus autofluorescence (FA) and spectral domain optical coherence tomography (SDOCT) findings in serpiginous choroiditis. DESIGN: Case report. METHODS: SDOCT and FA imaging of a 37-year-old woman with bilateral recurrent serpiginous choroiditis. RESULTS: Active new lesions disclosed hyperautofluorescence, in contrast to hypoautofluorescent scarred lesions. SDOCT showed increased reflectance of the choroid and deeper retinal layers, along with disruption of the photoreceptor inner and outer segment junction in both active and inactive lesions. CONCLUSION: Autofluorescence imaging and SDOCT are useful noninvasive methods for the evaluation of serpiginous choroiditis. Autofluorescence imaging allows identification of recurrences and retinal pigment epithelium involvement in the follow-up of this disease.

Spectral domain optical coherence tomography and angiographic findings in central serous chorioretinopathy complicated by bilateral nonrhegmatogenous retinal detachment associated with systemic corticosteroids.

PURPOSE: To report spectral domain optical coherence tomography (OCT) and angiographic findings in exudative retinal detachment complicating central serous chorioretinopathy. DESIGN: interventional case report. METHODS: 33-year old man with bilateral nonrhegmatogenous retinal detachment, misdiagnosed as uveitis, iatrogenically treated with systemic corticosteroids. RESULTS: Discontinuation of corticotherapy led to anatomic and visual improvement. Fluorescein angiography demonstrated multiple leakage points; indocyanine green angiography disclosed large hyperfluorescent patches in the choroid and OCT demonstrated retinal detachment with dense subretinal deposits. CONCLUSION: The recognition of this atypical presentation with a combination of opthalmoscopic, angiographic and OCT findings may avoid inappropriate diagnosis and treatment with corticosteroids.

Intraocular viral and immune pathogenesis of immune recovery uveitis in patients with healed cytomegalovirus retinitis.

PURPOSE: To investigate immune and viral contributions to the pathogenesis of immune recovery uveitis (IRU), which presents as vitritis, macular edema, or formation of epiretinal membranes, and develops in patients with acquired immunodeficiency syndrome (AIDS) who experienced cytomegalovirus (CMV) retinitis before antiretroviral treatment (ART) induced immune reconstitution. METHODS: Aqueous and vitreous fluids from patients with IRU, active CMV retinitis, and control human immunodeficiency virus (HIV)-negative, noninflamed eyes were compared for presence of cytokines IL-6, IL12, interferon gamma using enzyme-linked immunosorbent assay techniques, and CMV DNA (by polymerase chain reaction). RESULTS: IRU eyes (11 patients, 18 samples) had the highest levels of IL-12 (median 48 pg/mL), moderate levels of IL-6 (median 146 pg/mL), and low but significant interferon gamma (median 15 pg/mL), compared to controls (P < 0.01). All uveitis eyes tested (9/9) were CMV DNA negative. In contrast, active CMV retinitis eyes were CMV DNA positive, had higher levels of IL-6 (median 349 pg/mL) (25 patients, 41 samples) than both control (P = 0.0001) and uveitis eyes (P = 0.048), similar levels of interferon gamma (median 27 pg/mL) to uveitis eyes, but less IL-12 (median 0 pg/mL) than uveitis eyes. CONCLUSIONS: Inflammatory IRU can be differentiated from active CMV retinitis by the presence of IL-12, less IL-6, and absence of detectable CMV replication.