The purpose of this study was to determine the prevalence of retinal disease in a group of patients with AIDS in Malawi. Indirect ophthalmoscopy was performed on 99 patients with AIDS who were admitted consecutively to a medical ward at a central hospital. Necrotising retinitis was present in one eye of one patient examined. Non-infectious retinopathy was present in 13%. Retinitis is less common in AIDS patients from Africa compared with those from developed countries; it is believed that most patients die before acquiring it. Non-infectious retinopathy may also be less common.
PIP: Retinal diseases and destructive eye pathology have been recognized in patients with HIV infections and acquired immunodeficiency syndrome (AIDS). Opportunistic viral agents such as herpes simplex virus, cytomegalovirus, and varicella zoster virus have also been described in severe cases of retinitis. Most of these studies have been carried out in developed countries. This article reports the findings of a Malawian study in which 99 AIDS patients (63 men and 36 women) were examined for retinal pathology. A diagnosis of AIDS required a positive enzyme-linked immunosorbent assay (ELISA). 58 patients (58.6%) had pulmonary tuberculosis (TB) and 10 others (10.1%) had extrapulmonary TB. Indirect ophthalmoscopy was performed on all patients. 73 patients (73.7%) had normal eye examinations; 1 patient (1.0%) was found to have necrotizing retinitis; only 13 patients (13.1%) showed noninfectious retinopathy. These studies suggest that retinitis is less common in sub-Saharan Africa than in developed countries. Tuberculosis was the most common opportunistic infection found in this study.