AMD is a leading cause of visual impairment and blindness in persons older than 65 years.
1,2 Although there are regional differences in the prevalence of AMD, globally, it is estimated that the number of persons with AMD will be 196 million in 2020 and 288 million by 2040.
3 AMD typically is staged as early, intermediate, or late. Early-stage AMD consists of small drusen. Intermediate-stage AMD consists of extensive medium-size drusen or any large drusen, with or without pigment changes. Late-stage AMD is defined by the presence of either choroidal neovascularization or geographic atrophy.
4–7 Antiretroviral-treated, immune-restored, human immunodeficiency virus (HIV)-infected persons have a marked reduction in the incidence of opportunistic infections and a substantially increased life span compared with those from the era before modern combination antiretroviral therapy (cART).
8–11 Despite these improvements, antiretroviral-treated, immune-restored, HIV-infected persons have a substantially shortened life span compared with similarly aged, HIV-uninfected peers, which largely is due to an increased risk of non-AIDS diseases associated with aging (e.g., cardiovascular disease, non-AIDS cancers, metabolic diseases, and neurocognitive decline).
12–16 This increased risk of age-related diseases suggests that antiretroviral-treated, immune-restored, HIV infection is associated with an “accelerated and/or accentuated aging” phenotype.
12,16 Consistent with this accentuated aging, patients with AIDS have an approximately 4-fold increased age- and sex-adjusted prevalence of intermediate-stage AMD and an approximately 1.75-fold increased race- and sex-adjusted incidence of intermediate-stage AMD when compared with that in HIV-uninfected cohorts.
17,18 Patients with AIDS also have retinal vascular calibers consistent with those of HIV-uninfected persons who are on average 10 years older, again consistent with an accelerated/accentuated aging phenotype.
19 Therefore, we investigated the relationship between AMD and retinal vascular caliber in persons with AIDS enrolled in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA).