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Frank Verbraak, Nazli Demirkaya, Michael Abramoff, ; Loss of GCL in HIV positive patients with low (< 100) nadir CD4 counts. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5837.
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In HIV positive patients neurodegeneration is part of the overall co-morbity. Structural loss of neuro-retinal tissue has been described in these patients. We measured the individual retinal layers in search of posssible neuro-retinal degeneration.
Seventy-two HIV-positive patients were enrolled in this study. All underwent a complete ophthalmological examination. Patients with a history of retinitis or any other disease known to influence the retina were excluded (n=10). Patients were divided in two groups: patients with a nadir CD4 count > 100 (n=40), and patients with a nadir CD4 count less than 100 (n=22). Macular 3D volume OCT scans were made with SD-OCT (Topcon, MarckII), and segmented with custom-build software developed at the University of Iowa. Mean thickness of each individual layer was measured, and compared between both groups.
Of all layers measured the Ganglion Cell Layer (GCL) was the only statistically significant thinner layer in the group of patients with a low nadir CD4 count compared to patients with higher nadir CD4 counts: 31.6 micrometer (+/- 3.4), versus 33.8 micrometer (+/- 3.6), p = 0.03 (Man-Whitney U-test).
HIV-positive patients with a low nadir CD4 count (< 100) have a thinner macular GCL compared to HIV positive patients with higher nadir CD4 counts (>100), demonstrating structural neuro-retinal degeneration, which could be part of a more degeneralized neurodegeneration.
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