HIV-Associated Neuroretinal Disorder in Patients With Well-Suppressed HIV-Infection: A Comparative Cohort Study.
Invest Ophthalmol Vis Sci
; 57(3): 1388-97, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-27018841
ABSTRACT
PURPOSE:
Loss of neuroretinal structure and function, ascribed to a 'HIV-associated Neuroretinal Disorder' (HIV-NRD), in the absence of ocular opportunistic infections, has been reported in HIV-infected individuals treated with combination antiretroviral therapy (cART). Whether HIV-infected individuals with prolonged well-suppressed infection remain at risk for HIV-NRD, is unknown.METHODS:
Ninety-two HIV-infected men with suppressed viremia on cART for at least 12 months (HIV+) and 63 HIV-uninfected, highly comparable, male controls (HIV-), aged at least 45 years, underwent functional measurements of spatial (Pelli Robson contrast sensitivity [PR CS]) and temporal contrast sensitivity (TCS) and straylight, as well as spectral-domain optical coherence tomography analysis measured total and individual retinal layer thickness. Mixed-linear regression models were used to assess possible associations between HIV-related and ocular parameters, while accounting for several confounders.RESULTS:
Pelli Robson CS was significantly lower in HIV+ (1.89 vs. 1.93 logCS, P value = 0.001), while TCS values did not differ (2.17 vs. 2.17 logCS; P value = 0.888). Straylight values were higher in HIV+ (1.15 vs. 1.09 log units; P value = 0.026). Peripheral total retinal thickness in the HIV+ group was increased compared with HIV- (+4.6 µm, P value = 0.029), predominantly due to an increase in inner nuclear layer (+1.04 µm, P value = 0.006) and outer plexiform layer (+0.95 µm, P value = 0.006) thickness.CONCLUSIONS:
Pelli Robson CS was significantly reduced in HIV-infected individuals, although the loss was one letter and likely not clinically relevant. Instead of an expected neuroretinal thinning, an increase of retinal thickness was detected in the HIV-infected group. These findings should be confirmed and further explored in longitudinal studies. Clinical Trial registered at www.clinicaltrials.gov (identifier NCT01466582).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Retina
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Doenças Retinianas
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Acuidade Visual
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Infecções por HIV
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HIV
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article