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THE THICKNESSES OF CHOROID, MACULAR SEGMENTS, PERIPAPILLARY RETINAL NERVE FIBER LAYER, AND RETINAL VASCULAR CALIBER IN HIV-1–INFECTED PATIENTS WITHOUT INFECTIOUS RETINITIS

Cetin, Ebru, N., MD, FEBO, FICO*; Sayin KUTLU, Selda, MD; Parca, Osman, MD*; Kutlu, Murat, MD; Pekel, Gökhan, MD, FEBO*

doi: 10.1097/IAE.0000000000002146
Original Study: PDF Only

Purpose: To evaluate choroidal, macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses and retinal vascular caliber alterations in HIV-1–infected patients without opportunistic infections.

Methods: This cross-sectional study included 45 HIV-1–infected patients and 47 healthy subjects. Spectral domain optical coherence tomography was used for assessment of choroidal, macular, peripapillary RNFL thicknesses and retinal vascular caliber alterations.

Results: The mean CD4 count was 426 ± 226 cells per milliliter and the mean HIV-1 RNA level was 1.8 × 105 ± 3.6 × 105 copies/mL in HIV-infected group. Central inner plexiform, superior photoreceptor, superior and nasal retinal pigment epithelium layers were thinner in HIV-infected patients compared with control subjects (P < 0.05). The differences in sectoral retinal thicknesses lost their significance after Bonferroni correction (P < 0.01). The average thickness of pericentral retina within 3 mm was thinner in the photoreceptor layer in HIV-infected patients compared with control subjects (P = 0.033). The differences in peripapillary RNFL thickness, choroidal thickness, and retinal vascular caliber were not significant between the groups. Choroidal thickness and pericentral outer plexiform were thinner, whereas peripapillary RNFL was thicker in newly diagnosed cases (16 patients) compared with patients having treatment for at least 4 months or longer (27 patients, P < 0.05, Mann–Whitney U test). HIV-1 RNA showed negative correlation with choroidal thickness (r = −0.435, P = 0.003) and positive correlation with peripapillary RNFL in central (r = 0.323, P = 0.032) and superonasal (r = 0.369, P = 0.014) sectors.

Conclusion: Choroidal thickness was thinner in newly diagnosed patients compared with patients on treatment. Viral load showed negative correlation with choroidal thickness. Retinal segmental alterations occurred in HIV-infected patients compared with control subjects.

This study evaluates the posterior segment alterations in detail in HIV-infected patients without infectious retinopathy. To our knowledge, this is the first study assessing choroidal thickness in HIV-infected patients. Choroidal thickness was significantly thinner in newly diagnosed cases compared with HIV-infected patients on treatment, and it negatively correlated with HIV RNA.

Departments of *Ophthalmology, and

Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey.

Reprint requests: Ebru N. Cetin, MD, FEBO, FICO, Pamukkale Üniversitesi Hastanesi Göz Hastaliklari AD, Kinikli Kampüsü, Kinikli, Denizli 20070, Turkey; e-mail: cetin.ebru@gmail.com

Presented in part at the 17th EURETINA Congress, Barcelona, Spain, September 7–10, 2017.

None of the authors have any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.