Abstract
Purpose :
Patients with the acquired Immunodeficiency syndrome (AIDS) have an ~4-fold increased prevalence and an ~1.75-fold increased incidence of intermediate-stage age-related macular degeneration (AMD) compared to HIV-uninfected persons. We investigated the relationship between retinal vascular caliber and AMD among participants enrolled in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA).
Methods :
Participants enrolled in LSOCA had retinal photographs taken at enrollment. Photographs were evlauated at a reading center for intermediate-stage AMD using the AREDS grading system and for retinal vascular caliber using published, semi-automated techniques. Retinal vascular caliber measurements were reported as the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
Results :
Of the 1171 participants evaluated, 110 (9.4%) had AMD and 1061 (90.6%) did not have AMD. Participants with AMD had larger mean CRAE (151 ± 16 μm) than participants without AMD (147± 16 μm, P=0.009) and larger mean CRVE (228 ± 24 μm) than participants without AMD (223 ± 25 μm, P=0.02). After adjustment for age, race/ethnicity, gender, human immunodeficiency virus (HIV) transmission category, smoking, enrollment and prior nadir CD4+ T cell counts, and enrollment and prior maximum HIV load, the differences between participants with and without AMD were: CRAE, 5.4 μm (95% CI 2.3, 8.5; P=0.001) and CRVE, 6.0 μm (95% CI 1.4, 10.6; P=0.01).
Conclusions :
In patients with AIDS, AMD is associated with dilated retinal vessels, both arterioles and venules, suggesting a role for shared pathogenetic mechanisms, such as persistent systemic inflammation.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.