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Nazli Demirkaya, Ferdinand W. N. M. Wit, Thomas J. T. P. van Den Berg, Katherine W. Kooij, Maria Prins, Reinier O. Schlingemann, Michael D. Abramoff, Peter Reiss, Frank D. Verbraak, on behalf of the AGEhIV Cohort Study Group; HIV-Associated Neuroretinal Disorder in Patients With Well-Suppressed HIV-Infection: A Comparative Cohort Study. Invest. Ophthalmol. Vis. Sci. 2016;57(3):1388-1397. doi: https://doi.org/10.1167/iovs.15-18537.
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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.
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.
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.
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).
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