Abstract
Purpose:
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.
Methods:
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.
Results:
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).
Conclusions:
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.
Keywords: 550 imaging/image analysis: clinical •
612 neuro-ophthalmology: diagnosis