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Petrina Tan, Owen K. Hee, Carol Y. Cheung, Tun Kuan Yeo, Rupesh Agrawal, James Ng, Claire Han, Tock H. Lim, Tien Y. Wong, Stephen C. Teoh; Prospective Evaluation of Retinal Microvascular Parametric Changes in Patients with HIV. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2657.
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To measure and compare retinal vascular parameters between patients infected with Human Immunodeficiency Virus (HIV) and controls, and to elicit the relationship between retinal vascular parameters and CD4 counts.
Prospective observational case-control study. 37 HIV patients with no clinical retinal pathology and 111 age-gender matched normal healthy controls from Singapore population-based studies were recruited. Standard retinal photographs were taken centered around the optic disc. Quantitative retinal vascular parameters (retinal vascular caliber, branching angle, tortuosity and fractal dimension) were measured from the photographs using a semi-automated computer-based program (Singapore I Vessel Assessment, version 3.0) by trained technicians following a standardized protocol.
Patients with HIV were more likely to have higher total fractal dimension (1.457 vs. 1.439, p=0.045), higher venular fractal dimension (1.246 vs. 1.218, p=0.004), more tortuous arterioles (0.741 vs. 0.560 [x105], p<0.001) and venules (0.883 vs. 0.717 [x105], p<0.001), compared with healthy normal subjects. Amongst the HIV patients, decreased CD4 counts was independently associated with narrower retinal arteriolar caliber (β=0.060, p=0.006), after adjusting for age, gender, duration of HIV, hypertension and diabetes.
HIV is associated with unique retinal microvascular parametric changes. A linear relationship between CD4 counts and retinal vascular parameters is present.
National Healthcare Group, 2010/00675
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