ANN OPHTHALMOL. 2000; 32(4):289–294 289 Reprints: F. M. Honrubia, MD, Department of Ophthalmology, Miguel Servet Hospital, Pº Isabel La Católica, 1-3, Zaragoza 50009 Spain. Drs. Honrubia, Torrón, Ferrer, González, Larrosa, and Polo are from the Department of Ophthalmology, and Dr. Ramos is from the Department of Infectious Disease, Hospi- tal Miguel Servet, Zaragoza, Spain. ORIGINAL ARTICLE O cular involvement is frequent in patients with acquired immunodeficiency syndrome (AIDS), with an incidence of 75% in postmortem studies. 1 Clin- ical findings are somewhat less frequent. 2 The most frequent ocular finding is retinal cotton-wool exudates, and the most serious is opportunistic infectious retini- tis. Recent autopsy studies showed a decrease of up to 40% in the number of optic nerve fibers in patients without any prior history of infectious retinal disease. 3 Clinically, persons infected with the human immunodeficiency virus (HIV) who have no history of retinal opportunistic infection complain of poorly defined visual alterations. 4 Visual exploration tech- niques, such as chromatic vision tests or contrast sen- sitivity tests, have shown considerable dysfunction of the macula and/or optic nerve in these patients. The visual alterations had been attributed to a generalized involvement of retinal ganglion cells due to the HIV virus. 3 Monochromatic red-free retinal photographs demonstrated the retinal nerve fiber degeneration in HIV-positive patients, where the presence of cotton- wool exudates in the retina was not the determining factor for this degeneration. 5 The purpose of this study was to correlate the reti- nal nerve fiber layer (RNFL) degeneration and the extent of visual field abnormalities with the severity of HIV infection. Subjects & Methods Forty-one eyes of 22 individuals (age range, 21 to 62 years) with a history of HIV-positive infection were Francisco M. Honrubia, MD, Clemencia Torrón, MD, Eugenio Ferrer, MD, Immaculada González, MD, Carlos Ramos, MD, José M. Larrosa, MD, & Vicente Polo, MD Exploration of Retinal Nerve Fiber Layer and Visual Field in Patients With Human Immunodeficiency Virus A retinal nerve fiber layer (RNFL) evaluation and automated perimetry were performed in 41 eyes of patients with the human immunodefi- ciency virus (HIV) but without previous retinal or optic nerve disease. Cases with diffuse atrophy in RNFL represented 8%, 62.5%, and 77% in groups 1 through 3, respectively. Normal visual fields were present in 33% in group 1, 12.5% in group 2, and 7.5% in group 3. ABSTRACT