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Dirk-Uwe G Bartsch, Maria Laura Gomez, Laurie Dustin, Stanley Paul Azen, William R Freeman; Cross-Sectional Analysis of Structural and Functional Parameter in Patients with HIV and Normal Controls. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2196.
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To study the correlation between structural tests and functional tests of the retina, and their relationship to standard clinical assessment of HIV status.
Our study was a prospective longitudinal observational study of 237 patients with HIV and normal HIV negative volunteers. Standard ophthalmic evaluation was performed. Three different devices were used for structural tests (scanning laser polarimeter (SLP), scanning laser tomograph (SLT) temporal domain-OCT (TD-OCT) and spectral-domain OCT (SD-OCT with Spectralis). Functional parameter were Humphrey Visual Field test (HVF), FM 100 Hue color test (FM100), Pelli-Robson contrast sensitivity test (CS), and multifocal electroretinography (mfERG). The overall medical assessment included number of opportunistic infections (OI), National Eye Institute Visual Function Questionnaire (VFQ-25), HIV status. The patients were additionally sorted according to the lowest CD4 count every recorded during observation into three groups: high (CD4≥200), low (CD<200), and HIV negative. General estimating equation (GEE) was used to estimate the correlation between different groups.
In a first analysis we correlated the structural and functional parameter the number of opportunistic infections (OI). We found that SLP nerve fiber indicator was positively correlated with the total number of OIs, while the temporal and temporal-superior regions of the RNFL area acquired with the SLT were negatively associated with the total number of OI. Among the functional parameter, we found that mean defect and pattern standard deviation visual field were significantly correlated with the number of OI. We also found a correlation when looking at the mfERG latency in the outer ring. We found a positive correlation between structural parameter and HIV status with the SLP-NFI parameter, but no correlation with SLT, TD-OCT or SD-OCT. Among the functional parameter, we found that the mean defect and pattern standard deviation visual field were significantly correlated with HIV status, as was the color vision test and the mfERG latency N1 overall and in the peripheral ring (ring 6).
Our results indicate that patients with HIV undergo functional changes in the eye that are correlated with severity of disease and duration of disease. Structural measures were also correlated with disease severity and duration. Further studies are underway.
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