The long-term effect of human immunodeficiency virus infection on retinal microvasculature and the ganglion cell-inner plexiform layer: an OCT angiography study

Graefes Arch Clin Exp Ophthalmol. 2020 Aug;258(8):1671-1676. doi: 10.1007/s00417-020-04749-x. Epub 2020 May 22.

Abstract

Purpose: To investigate the long-term effect of HIV infection on the ganglion cell-inner plexiform layer and retinal capillary network.

Methods: This prospective, cross-sectional case-control study included 45 HIV-infected patients and 45 healthy individuals. Optical coherence tomography angiography (OCTA) was used for the assessment of macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses, ganglion cell-inner plexiform layer, vessel density, perfusion density, and foveal avascular zone.

Results: The mean disease duration was 7.3 ± 1.9 years (range, 5-12 years) in the HIV group. The mean CD4 count (nadir) for all the patients was 147.09 ± 122 cells/mm3 and the mean RNA was 173.6 ± 913.8 copies/ml. No statistically significant difference was determined between the groups in respect of the average and foveal MT (p = 0.05). A significant difference was found between the two groups in respect of the mean VD and PD parameters (p < 0.05). Peripapillary PD was significantly decreased in the HIV group. There was a significant difference between the average and superior and inferior half-region of GC-IPL values. Using Pearson's correlation analysis, no significant correlation was determined between the duration of HIV infection and mean GC-IPL, MT and VD, and PD values (r - 0.223, p 0.141; r - 0.223, p 0.141; r - 0.169, p 0.268; r - 0.105, p 0.491; r - 0.095, p 0.535 respectively).

Conclusions: The results of this study provide evidence of microvascular and neuroretinal loss in individuals with well-suppressed HIV infection, compared with healthy control subjects. OCTA is an important test for the screening of retinal microvascular changes over time in HIV-infected cases.

Keywords: GC-IPL; HIV infection; Macula; RNFL; Retinal capillary.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Eye Infections, Viral / diagnosis*
  • Female
  • Fluorescein Angiography / methods*
  • Follow-Up Studies
  • Fundus Oculi
  • HIV Infections / diagnosis*
  • HIV*
  • Humans
  • Male
  • Microvessels / pathology*
  • Nerve Fibers
  • Prospective Studies
  • Retinal Ganglion Cells / pathology*
  • Time Factors
  • Tomography, Optical Coherence / methods*