April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Neuroretinal degeneration in HIV
Author Affiliations & Notes
  • Nazli Demirkaya
    Ophthalmology, Academic Med Ctr Amsterdam, Amsterdam, Netherlands
  • Ferdinand Wit
    Infectious Diseases, Academic Medical Center, Amsterdam, Netherlands
    Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
  • Tanja Su
    Radiology, Academic Medical Center, Amsterdam, Netherlands
  • Ineke Stolte
    Municipal and Regional Health Service, Amsterdam, Netherlands
  • Katherine Kooij
    Infectious Diseases, Academic Medical Center, Amsterdam, Netherlands
    Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
  • Thomas J T P Van Den Berg
    Netherlands Ophthalmic Research Institute, Amsterdam, Netherlands
  • Michael David Abramoff
    Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa, IA
    Biomedical Engineering, Iowa Institute for Biomedical Imaging, Iowa, IA
  • Peter Reiss
    Infectious Diseases, Academic Medical Center, Amsterdam, Netherlands
    Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
  • Frank D Verbraak
    Ophthalmology, Academic Med Ctr Amsterdam, Amsterdam, Netherlands
    Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships Nazli Demirkaya, None; Ferdinand Wit, None; Tanja Su, None; Ineke Stolte, None; Katherine Kooij, None; Thomas Van Den Berg, None; Michael Abramoff, None; Peter Reiss, Bristol Myers Squibb (F), Institution from Gilead Sciences (F), Janssen Pharmaceuticals (F), Merck (F), ViiV (F); Frank Verbraak, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2820. doi:
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    • Get Citation

      Nazli Demirkaya, Ferdinand Wit, Tanja Su, Ineke Stolte, Katherine Kooij, Thomas J T P Van Den Berg, Michael David Abramoff, Peter Reiss, Frank D Verbraak, ; Neuroretinal degeneration in HIV. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2820.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To detect possible neuro-retinal degeneration in HIV-positive patients by SD-OCT and contrast sensitivity tests.

Methods: One hundred and one HIV-positive patients and 71 HIV-negative control subjects were enrolled from the prospective AGEhIV cohort study on age-associated non-communicable co-morbidity in Amsterdam. All participants underwent a complete ophthalmological examination.Participants with a history of any disease known to influence the retina were excluded (n=20). Macular and optic disc 3D volume OCT scans were made with SD-OCT (Topcon). Mean thickness of each layer in the macula and the peripapillary retinal nerve fiber layer (RNFL) thickness were measured. Spatial (Pelli-Robson charts) and temporal contrast sensitivity (assessed with the C-Quant) were measured. Ocular straylight was also assessed with the C-Quant. Multivariable mixed linear regression was used to assess associations between several HIV related factors and ocular examinations.

Results: Correcting for age, spherical equivalent, and OCT image quality, we did not find a significant difference in retinal layer thickness between HIV-patients and controls. Patients had a significantly lower, although small (1 letter) difference in spatial contrast sensitivity compared with controls, but no differences in temporal contrast sensitivity. Straylight values were significant higher in patients compared to controls. In the patients, we observed a significant negative association between CD8 counts at time of examination and RNFL and GCL thickness. Other investigated potential determinants were not associated with RNFL and GCL thickness: current CD4 count and %, CD8 %, CD4/8-ratio and markers of inflammation (soluble CD14 and CD163); nadir CD4 count; duration of immunodeficiency; prior AIDS diagnosis; documented duration of HIV-infection; duration of anti-retroviral therapy; prior use of d4T/ddC/ddI.

Conclusions: In contrast to other reports, no significant difference was observed in retinal structure measured with OCT between HIV-positive patients and HIV-negative controls. Only the absolute CD8 count was negatively associated with RNFL and GCL thickness in HIV-positive patients. Higher CD8 counts in HIV-infection are associated with residual HIV-replication, chronic antigenic stimulation, and chronic T-cell activation, which may all play a role in retinal degeneration. The slightly lower spatial contrast sensitivity in HIV-patients could be explained by higher glare values.

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 688 retina • 415 AIDS/HIV  
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