Abstract
Purpose: :
To evaluate the retinal nerve fiber layer (RNFL) thickness in various quadrants of the retina using OCT in patients known to be HIV positive and to investigate a possible correlation between duration of HIV disease and RNFL thickness in all quadrants.
Methods: :
A retrospective chart review and analysis was performed on 157 eyes of 84 consecutive HIV positive patients. OCT measurements were done with a Zeiss Stratus, model 3000, version 4.0.1. Data was analyzed using Microsoft Excel and ANOVA. Patients were divided into 4 groups based on duration of HIV disease: 0–5 yrs, 6–10 yrs, 11–15 yrs, 16–26 yrs. RNFL thickness was calculated in the superior, inferior, temporal and nasal quadrants in each eye. RNFL thicknesses in the different quadrants were compared to each other, between the different groups of HIV duration, and to literature standards of HIV negative patients. Correlation coefficient was calculated between RNFL thickness and duration of disease in each quadrant.
Results: :
Average age of our patients was 51 years old. We found a mean RNFL thickness in the superior quadrant of 53.01 microns, in the inferior quadrant of 54.46 microns, in the nasal quadrant of 51.65 microns, and in the temporal quadrant of 36.19 microns. ANOVA analysis revealed no significant difference when the superior, inferior, and nasal quadrants were compared (p=0.8). However, there was a significant difference when the temporal quadrant was compared with the other quadrants (p=0.00006). Student’s t– test revealed thinner temporal quadrants when compared with the other quadrants in all 4 groups of HIV disease duration: 0–5 yrs (p= 0.01–0.004), 6–10 yrs (p=0.002–0.004), 11–15 yrs (p=0.001–0.0004), 16–26 yrs (p=0.01–0.003). The correlation coefficient between duration of disease and RNFL was 0.12 in the superior quadrant, 0.065 in the inferior quadrant, 0.049 in the nasal quadrant, and 0.19 in the temporal quadrant. When our patient population was compared to the HIV negative standard found in the literature, the HIV positive patients had thinner RNFL in all quadrants.
Conclusions: :
We found there to be a significant difference in the RNFL thickness amongst patients positive for HIV between the temporal quadrant and the other three quadrants. When compared to RNFL thickness standards in existing literature, there was thinning in the HIV positive patients in all quadrants. We found there to be no significant correlation between duration of HIV disease and RNFL thicknesses in all quadrants.
Keywords: AIDS/HIV • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina