Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.

Publications // Ronald Danis // Mar 01 2012

PubMed ID: 22019221

Author(s): Kalyani PS, Fawzi AA, Gangaputra S, van Natta ML, Hubbard LD, Danis RP, Thorne JE, Holland GN; Studies of the Ocular Complications of AIDS Research Group. Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function. Am J Ophthalmol. 2012 Mar;153(3):428-433.e1. doi: 10.1016/j.ajo.2011.08.027. Epub 2011 Oct 22. PMID 22019221

Journal: American Journal Of Ophthalmology, Volume 153, Issue 3, Mar 2012

PURPOSE To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS.

DESIGN Longitudinal, observational cohort study.

METHODS We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Field Analyzer), and contrast sensitivity (CS) testing. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, sought independent relationships between indices and visual function variables.

RESULTS Included were 1250 participants. Smaller AVR was associated with reduced visual field by Goldmann perimetry (P = .003) and worse mean deviation (P = .02) on automated perimetry and possibly with worse pattern standard deviation (PSD) on automated perimetry (P = .06). There was a weak association between smaller AVR and worse CS (P = .07). Relationships were independent of antiretroviral therapy and level of immunodeficiency (CD4+ T lymphocyte count, human immunodeficiency virus [HIV] RNA blood level). On longitudinal analysis, retinal vascular indices at baseline did not predict changes in visual function.

CONCLUSIONS Variation in retinal vascular indices is associated with abnormal visual function in people with AIDS, manifested by visual field loss and possibly by reduced CS. Relationships are consistent with the hypothesis that HIV-related retinal vasculopathy is a contributing factor to vision dysfunction among HIV-infected individuals. Longitudinal studies are needed to determine whether changes in indices predict change in visual function.

Copyright © 2012 Elsevier Inc. All rights reserved.