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P. S. Kalyani, A. A. Fawzi, S. Gangaputra, M. L. Van Natta, G. N. Holland, Studies of the Ocular Complications of AIDS Research Group; Evaluation of Retinal Vessel Caliber in People with AIDS. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4856.
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To evaluate measures of retinal vessel caliber among people with AIDS, and to identify their relationships with other factors.
Cross-sectional analyses using data from enrollment examinations for participants in the Longitudinal Studies of the Complications of AIDS. Excluded were those with ocular opportunistic infections. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriovenular ratio (AVR). Multiple linear regression models using forward selection identified independent relationships between these parameters and various host- and disease-related factors.
Included were 1242 participants. Larger CRAE was related to lower hematocrit (HCT; p=.003). Smaller CRAE was related to increased age (p=.002), history of hypertension (p=.02), and history of highly active antiretroviral therapy (HAART) use (p=.01). Larger CRVE was related to smoking (p=.003). Smaller CRVE was related to longer AIDS duration (p=.02), higher mean corpuscular volume (MCV; p<.001), and history of HAART use (p=.02). Larger AVR was related to lower HCT (p=.001). Smaller AVR was related to history of hypertension (p=.01) and smoking (p=.04). Visual field (VF) loss was related to smaller CRAE and AVR (both p=.004). Parameters were not related to the following measures: CD4+ and CD8+ T-lymphocyte counts; HIV blood level.
Results suggest that AIDS-specific factors (AIDS duration; HAART use) are associated with retinal vessel changes that may affect visual function, as manifested by VF loss. Observed patterns of change are consistent with the hypothesis that the retinal vasculature is altered by the known atherogenic effects of chronic HAART or the prolonged inflammatory state associated with HIV disease or both. Further study is warranted to determine whether these changes predict long-term cardiovascular morbidity and mortality among people with AIDS.
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