Dr Alvin Munsamy graduated with a PhD in Optometry.

Visual Function in NIPLHIV Study Earns Optometrist a Doctorate

Optometry academic, Dr Alvin Munsamy, graduated with a doctoral degree for his study titled: The Impact of Structural Retinal Changes on Visual Function in Non-Immunocompromised People Living with HIV (NIPLHIV).

The novel study highlights the importance of monitoring the eye structure and vision of NIPLHIV, which is an often neglected area, given that these patients are on Antiretroviral Therapy (ART).

According to Statistics South Africa, in 2018, South Africa had 7.7 million people living with HIV (PLHIV). Since HIV suppresses the immune system, the body, including the eyes, are susceptible to a number of infections. It is believed that since the majority of PLHIV are on ART, their immune system is not compromised and they are in relatively good health. Munsamy’s study sought to understand the retinal structure in PLHIV on ART as well as the neuro-ophthalmic associations in NIPLHIV.

The study was conducted on 30 HIV negative patients and 30 NIPLHIV attending an outpatient clinic in a local hospital in Durban. Patients’ retinal morphometric measurements were assessed using the Spectralis Optical Coherence Tomographer (OCT). A number of other optometric tests were used to obtain Contrast Sensitivity (CS), colour vision error scores and pattern evoked potentials to assess visual function.

According to Munsamy, ‘NIPLHIV had thicker mean global temporal sub-fields when compared to the HIV negative controls; however, no visual differences in function were observed in both the groups. Essentially, the structural differences observed could be a precursor for visual function disorders despite the fact that these NIPLHIV are on ART.’

Munsamy’s study recommends that OCT of the macula (responsible for focusing central vision in the eye) and Contrast Sensitivity (CS) loss be used as markers of cerebral atrophy in NIPLHIV. ‘Even if you appear healthy and you have HIV, ask your eye care provider to photo-document retinal scans at least annually as sub-clinical changes exist. Taking ART prevents retinal inflammation and disease, but the underlying structure is disrupted and we have yet to see the long-term effects.’

Munsamy was supervised by Professor Anand Moodley, Head of Neurology at the University of the Free State and Professor Rune Brausatet, Head of the Division – Eye and Vision, Karolinska Institutet, Sweden. He has supervised a number of master’s students and his area of expertise lies in binocular vision and ocular disease.

The Dr AD Lazarus old boy graduated with his bachelors and master’s degrees at UKZN. He also has a Certification in Advanced Study in Diagnosis and Treatment of Ocular Diseases and Neural Basis of Optometry from the New England College of Optometry and has completed courses offered for certification in therapeutic management of ocular disease, from the State University of New York. Munsamy is a fellow of the prestigious Developing Research Innovation, Localisation and Leadership in South Africa (DRILL), a flagship project of UKZN’s College of Health Sciences funded by a D43 US National Institutes of Health International Research Training Award.

Having grown up in the Clare Estate/Reservoir Hills area close to UKZN’s Westville campus, Munsamy is well-known for his love of Ferrari F1 racing, Ster Kinekor movies and the tennis grand slam champion, Roger Federer.

Words: MaryAnn Francis

Photograph: Supplied