The neuro-ophthalmology of HIV-AIDS review of Neurobehavioral HIV Medicine

Padmaja Sudhakar,¹ Sachin Kedar,^1,2 Joseph R Berger<sup>1,3

1</sup>Departments of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA; ²Departments of Ophthalmology, University of Kentucky College of Medicine, Lexington, KY, USA; ³Departments of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA

Abstract: Neuro-ophthalmic problems are known to occur both in human immunodeficiency virus (HIV) infection and AIDS. Central nervous system (CNS) opportunistic infections and malignancies such as lymphoma are the major source of these problems but some result from the direct effect of the virus on the CNS. Both the afferent visual pathway and efferent ocular motor system may be affected. Neuro-ophthalmic signs may sometimes be the initial manifestation of AIDS. A variety of neuro-ophthalmic manifestations may be encountered in the same patient. Several large studies on the ophthalmic features of AIDS have included neuro-ophthalmic manifestations in their series. However dedicated comprehensive review articles on this subject are few. Despite the introduction of highly active antiretroviral therapy (HAART), neuro-ophthalmic manifestations still remain a problem in HIV. The aim of this article is to provide an overview of the neuro-ophthalmic sequelae of AIDS.

Keywords: HIV, AIDS, ophthalmology, eye, pupil, cranial nerve, ocular motility, visual loss