Study to evaluate efficacy of midriatic-digital-images when screening retinal-complications in people living with HIV

To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in people living with HIV, in this study, a consecutive series of 79 people living with HIV (PLHIV) were evaluated. Two series of MDI were taken: - macula and optic nerve - nine gaze fields, which findings were compared with those obtained by a retina specialist. Both examiners were unaware of each other's results. Average age was 32.2 years old, predominantly male (75.9%). Most frequent complications were HIV retina microangiopathies (6.3%) and toxoplasmosis (5.1%), followed by Cytomegalovirus and neuro-retinitis, optic neuritis and vitreitis, each one with 1.3%. Sensitivity with two MDI was 92.8% (CI 95% 66.0-100.0) and with nine 100% (CI 95% 77.0-100.0) and specificity of 95.4% (CI 95% 87.0-99.0) for both series. The positive predictive value was 81.3 and 82.4%, and negative predictive value was 98.4 and 100% respectively. The strength of agreement was substantial for the two series with the retina specialist examination (Kappa index of 0.836 and 0.888 respectively). Mydriatic-digital-images appear to be an effective method to screen for HIV-related retinal-complications in a regional hospital in Peru.