Jian-Yu E1, Zhengfan Wang2, Joseph Ssekasanvu1, Beatriz Munoz3, Sheila West3, James Ludigo4, Ronald Gray1, Gertrude Nakigozi4, Xiangrong Kong1,3,5,6. 1. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA. 2. School of Public Health and Health Sciences, University of Massachusetts , Amherst, Massachusetts, USA. 3. Wilmer Eye Institute, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA. 4. Rakai Health Sciences Program , Kalisizo, Uganda. 5. Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA. 6. Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA.
Abstract
PURPOSE: Antiretroviral therapy reduced infectious eye diseases (EDs) in HIV-infected people. There is limited data on age-related EDs and visual impairment (VI) in people living with HIV. We report prevalence of VI and spectrum of EDs in HIV-infected people in an ART era in Rakai, Uganda. METHODS: A philanthropic campaign during 2009-2012 provided ophthalmic services to HIV+ patients in care. Unilateral presenting visual acuity (VA) was assessed by a trained staff in HIV clinics using a 6-m Snellen chart. A slit-lamp examination by an ophthalmologist evaluated eyes with impaired acuity. A retrospective chart review was later conducted retrieving data of patients participating the ophthalmic service. VI was defined referencing WHO's ICD-11. Ophthalmic diagnosis was summarized by VI level. Logistic regressions estimated demographic associations with cataract diagnosis. RESULTS: 688 HIV+ patients were evaluated, median age was 44 (IQR: 37-50) years, 69% were female. Fifty-one percent were on ART (median duration 4, IQR: 2-5 years). Crude prevalence of moderate/severe VI and blindness were both 2%. The main diagnoses were refractive error (55%), conjunctivitis (18%), cataract (15%), and pterygium (11%). Cataract prevalences were 10%, 12%, and 26% among age groups of 19-34, 35-49, and ≥50 years, respectively. Cataract was found in 73% of the HIV+s with blindness and in 63% of those with moderate/severe VI. Older age and male sex were significantly associated with higher cataract prevalence. CONCLUSION: VI in HIV+ patients in Rakai was mainly due to refractive error and cataract. Cataract was common in all age groups.
PURPOSE: Antiretroviral therapy reduced infectious eye diseases (EDs) in HIV-infected people. There is limited data on age-related EDs and visual impairment (VI) in people living with HIV. We report prevalence of VI and spectrum of EDs in HIV-infected people in an ART era in Rakai, Uganda. METHODS: A philanthropic campaign during 2009-2012 provided ophthalmic services to HIV+ patients in care. Unilateral presenting visual acuity (VA) was assessed by a trained staff in HIV clinics using a 6-m Snellen chart. A slit-lamp examination by an ophthalmologist evaluated eyes with impaired acuity. A retrospective chart review was later conducted retrieving data of patients participating the ophthalmic service. VI was defined referencing WHO's ICD-11. Ophthalmic diagnosis was summarized by VI level. Logistic regressions estimated demographic associations with cataract diagnosis. RESULTS: 688 HIV+ patients were evaluated, median age was 44 (IQR: 37-50) years, 69% were female. Fifty-one percent were on ART (median duration 4, IQR: 2-5 years). Crude prevalence of moderate/severe VI and blindness were both 2%. The main diagnoses were refractive error (55%), conjunctivitis (18%), cataract (15%), and pterygium (11%). Cataract prevalences were 10%, 12%, and 26% among age groups of 19-34, 35-49, and ≥50 years, respectively. Cataract was found in 73% of the HIV+s with blindness and in 63% of those with moderate/severe VI. Older age and male sex were significantly associated with higher cataract prevalence. CONCLUSION: VI in HIV+ patients in Rakai was mainly due to refractive error and cataract. Cataract was common in all age groups.
Authors: Noah Kiwanuka; Merlin Robb; Oliver Laeyendecker; Godfrey Kigozi; Fred Wabwire-Mangen; Fredrick E Makumbi; Fred Nalugoda; Joseph Kagaayi; Michael Eller; Leigh Anne Eller; David Serwadda; Nelson K Sewankambo; Steven J Reynolds; Thomas C Quinn; Ronald H Gray; Maria J Wawer; Christopher C Whalen Journal: J Acquir Immune Defic Syndr Date: 2010-06 Impact factor: 3.731