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Anne E. Baranano, Partho S. Kalyani, Amani A. Fawzi, David Huang, Ou Tan, Ranjith Konduru, Srinivas R. Sadda, Tiago E. Arantes, Fei Yu, Gary N. Holland; Reduced Retinal Blood Flow Among Individuals Infected with Human Immunodeficiency Virus. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4276.
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Abnormal retinal blood flow was identified among HIV-infected individuals during the years before and soon after highly active antiretroviral therapy (HAART) became available. We sought to determine whether abnormal retinal blood flow remains common in the current era of widespread HAART use.
Total retinal blood flow, calculated by summing the venous flow in the peripapillary retina, was determined for 11 HIV-infected individuals, all of whom were on HAART and without ocular opportunistic infections, using RTVue Doppler Fourier Domain optical coherence tomography and specialized software (Optovue, Inc, Fremont, CA). Findings were compared to 11 HIV-negative controls. Correlations were calculated between blood flow and the following factors: current and lowest previous CD4+ T-lymphocyte counts, current and highest HIV RNA blood levels, and duration of AIDS.
Mean total retinal blood flow was lower in HIV-infected individuals (38±7.8 uL/min [range: 22-47 uL/min]) when compared to controls (50±5.7 uL/min [range: 41-57 uL/min], p= 0.002, Wilcoxon rank sum test). All HIV-infected individuals were male, with mean age of 51.5 years (40-67 years) and mean CD4+ T-lymphocyte count of 569 cells/uL (range: 258-912 cells/uL). No correlations were confirmed between total blood flow values and the following factors among HIV-infected individuals: age (r=-0.1; p=0.7); current (r=-0.4; p=0.2) or lowest previous (r=-0.3; p=0.3) CD4+ T-lymphocyte count; highest previous HIV RNA blood levels (r=0.2; p=0.7); or duration of AIDS (r=-0.5; p=0.2).
Reduced retinal blood flow characterizes HIV disease, even among individuals on HAART who have experienced immune recovery. This phenomenon may have important implications for understanding the pathogenesis of HIV-related neuroretinal disorder and its associated visual dysfunction. Individuals with HIV disease are potentially at risk for on-going retinal damage.
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