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H. Dadgostar, G.N. Holland, X. Huang, A. Tufail, A. Kim, T. Fisher, W.G. Cumberland, H.J. Meiselman, A. Benjamin, D.–U. Bartsch; A Relationship Between Altered in vivo Retinal Microvascular Blood Flow and Leukocyte Rigidity in HIV–Infected Individuals . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3060.
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To evaluate retinal microvascular blood flow in individuals with human immunodeficiency virus (HIV) infection using scanning laser Doppler flowmetry (SLDF) and to correlate abnormal flow with multiple systemic hemorheologic indices.
Using the Heidelberg Retina Flowmeter and SLDF software retinal blood flow data was acquired from HIV–infected individuals (n = 24) and HIV–negative controls (n = 16). Separate scans represented each of six retinal regions: nasal peripapillary; macular; and superior, nasal, inferior and temporal periphery. RBC aggregation (assessed by Myrenne aggregometry, zeta sedimentation ratio [ZSR; a hematocrit–independent sedimentation rate], and serum fibrinogen level), plasma viscosity and WBC rigidity (measured using a cell transit analyzer) were compared to flow.
Topographic blood flow analysis revealed significantly faster flow in the periphery (superior, nasal, inferior, temporal) than in the central retina (nasal peripapillary, macular) with the most rapid flow observed in the temporal periphery (p<0.0001) for both HIV–infected and HIV–negative subjects. Microvascular flow in the central retina was significantly slower in HIV–infected subjects than in controls (p<0.0001). Among HIV–infected individuals, there was a significant negative correlation between macular blood flow and WBC transit time (r = –0.59, p = 0.0024) and a weaker negative correlation between macular blood flow and ZSR (r = –0.44, p = 0.0314).
Using a non–invasive in vivo measure, central retinal microvascular flow is shown to be reduced in HIV–infected individuals. Out of multiple potential influences on flow, WBC rigidity appears to play the strongest role in this blood flow reduction. Altered microvascular blood flow may contribute to retinal disease among HIV–infected individuals.
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