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Yosuke Hotta, Naomichi Katai; Outer retinal changes in Human Immunodeficiency Virus positive patients.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1494.
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© ARVO (1962-2015); The Authors (2016-present)
Human Immunodeficiency Virus (HIV) positive patients have impaired color vision and contrast sensitivity, which worsen with age. Inner retinal damage such as HIV retinopathy, however, cannot explain these symptoms. Thus, chronic outer retinal degeneration has been suspected in HIV positive patients. Kozak et. al. showed downregulation of cone-specific transcripts, the increased rate of rod outer segments synthesis, and the increased retinal pigment epithelium (RPE) phagocytic activity in HIV positive retina, which were consistent with outer retinal change in HIV positive patients. In addition, Jabs et. al. indicated HIV-infected patients had the increased risk of age-related macular degeneration even in younger generation. Here, we performed a retrospective, observational clinical study to evaluate outer retinal changes using Spectral Domain Optical Coherence Tomography (SD-OCT) and RPE changes using Fundus autofluorescence (FAF) in HIV positive patients.
SD-OCT and FAF images of 64 normal eyes of 64 male subjects and 73 eyes of 73 HIV positive male patients were studied. SD-OCT imaging was performed with a 30 degree angle of view. After the segmentation lines were automatically drawn, the thickness was measured between the lines of external limiting membrane and RPE (ELM-RPE) at foveola. Both near infrared and short wavelength FAF images in HIV positive patients were reviewed by three examiners.
The mean age was 47.0 years old in control and 47.5 years old in HIV positive patients, respectively. The mean thickness of ELM-RPE was 99.2±7.90µm in control and 99.1±6.37µm in HIV positive patient (p=0.93). The thickness of ELM-RPE was 100µm in control (n=26) and 101µm in HIV positive patients (n=28) aged 23-34 years (p=0.76), 101µm in control (n=21) and 100µm in HIV positive patients (n=28) aged 35-54 years (p=0.69), and 98.8µm in control (n=17) and 93.6µm in HIV positive patients (n=17) aged 55-80 years (p=0.0087). In 26 FAF images among 73 HIV positive patients, there were granular hyperfluorescence in near infrared FAF and speckled pattern in short wavelength FAF.
The decrease in the thickness of ELM-RPE at foveola using SD-OCT in elderly HIV positive patients may represent the degenerative structural changes of outer retina. In addition, the findings in FAF images may indicate the chronic changes of RPE due to HIV infection.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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