Ocular Manifestations in HIV-Positive Patients and Their Association with CD4 Count: A Cross-Sectional Study

Background: Ocular problems can occur as a complication of human immunodeficiency virus (HIV). Ocular manifestations in individuals with HIV may arise due to opportunistic infections, vascular anomalies, neoplastic growths, neuro-ophthalmic disorders, or unfavorable reactions to pharmaceutical agents. Regrettably, the extent of understanding regarding this phenomenon within the context of Iran remains constrained. Objectives: Considering the significance of the expanding population of people affected by HIV and the challenges presented by ocular manifestations, the aim of this study was to assess the ocular manifestations observed in people living with HIV (PLHIV) and their correlation with CD4 count. Methods: This cross-sectional study involved 114 PLHIV who were referred to the Behavioral Diseases Counseling Center connected to Hamadan University of Medical Sciences (UMSHA) in Hamadan Province, Iran. A thorough ocular assessment of both eyes was performed, which included measuring visual acuity (VA) using a Snellen chart, conducting an anterior segment examination with a slit lamp, measuring intraocular pressure (IOP) via Goldmann applanation tonometry, and performing a dilated fundus examination. Results: This cross-sectional study involved 114 PLHIV, comprising 75 males (65.8%) and 39 females (34.21%). Among the participants, 66 patients (57.89%) exhibited ocular manifestations. The most prevalent ocular issues were blepharitis (35.1%) and dry eye (28.1%). Furthermore, the average CD4 count in patients with retinal manifestations was significantly lower (380.89 cells/µL) compared to those with other ocular manifestations, with a P-value of 0.001. Conclusions: The results indicated that the rate of retinal manifestations was significantly greater in patients who were not receiving antiretroviral therapy (ART), and their CD4 count was notably lower. This highlights the crucial impact of treatment and immune system status on ocular manifestations in these patients.