CLINICAL APPLICATIONS & DISEASE - AIDS

Clinical Applications & Disease > AIDS

Contrast sensitivity and AIDS (Summary from: Kristine Morrill, OSN Staff Writer. Ocular Surgery News, November 1, 1991.) The use of contrast sensitivity testing may be one of the most sensitive methods for detection of AIDS-related diseases in HIV-positive people who are seemingly asymptomatic.

The conclusion is being reached as a result of a general vision screening offered since April at the Gibson Center for HIV Related Research in Houston, in which more than 140 HIV-positive people had been tested as of press time (this article was published in November 1991).

The data showed that 46.8% of those tested, who were otherwise asymptomatic, had contrast sensitivity deficits, most from various types of neuro-ophthalmological pathology.

Breakdown of Diseases

• 6% with abnormal tests were found to have cytomegalovirus (CMV) retinitis.
• 4% were found to have neuro-toxoplasmosis.
• 2% had cotton-wool spots.
• 1% had neurolymphoma
• 21% were found to have generalized neurological deficit.
• 10% were found to have refractive errors.

The director of the study at the Gibson Center, Fred Ussery III, MD, a neuro-ophthalmologist, told Ocular Surgery News that the results were far beyond what was expected.

"I certainly think we found things we weren't expecting to find and they center around the apparent sensitivity of visual contrast sensitivity testing and picking up early clinical asymptomatic CMV retinopathy," Ussery said.

The clinic began to incorporate contrast sensitivity testing into its protocol in 1988 to get a better look at central visual acuity after Ussery saw a number of reports on testing.

"We work specifically with neurological ophthalmic problems and we estimate that probably 20% to 25% of patients with AIDS will develop some type of ocular complications," said Kathi Redding, RN, C, CRNO, clinical director of the Gibson Center.

The longevity of AIDS patients increases each year, said Redding, which is good news for patients, but frequently means they will develop more numerous complications as their immune systems weaken.

"From a standpoint of an early screening device, I think (contrast sensitivity testing) is incredible," Redding said. "When I started HIV nursing seven years ago, AIDS patients lived an average of about two months. Now we're seeing people that are seven, eight, ten years into the illness-wellness."

Clinical Applications & Disease > AIDS

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