title: Ocular microangiopathic syndrome in patients with acquired immunodeficiency syndrome and its relationship to alterations in cell adhesion and in blood flow.
abstract: Ocular microangiopathic syndrome is the most frequent ophthalmic finding in patients with acquired immunodeficiency syndrome (AIDS). Ocular microvascular changes, including cotton-wool spots, are closely associated with neuroretinal and cognitive deficits in patients infected with the human immunodeficiency virus type 1 (HIV-1). Cell adhesion has become an important pathogenetic concept in infectious diseases. We studied 39 patients with AIDS by indirect ophthalmoscopy and by slit-lamp biomicroscopy. Cotton-wool spots were counted as an indicator of retinal microvasculopathy. Conjunctival blood-flow sludging in conjunctival vessels was determined by a standardized rating scale as an indicator of blood-cell adhesion abnormalities. Parameters of immunosystemic damage were determined by fluorescein-activated cell-sorter scan, radioimmunoassay, and enzyme-linked immunosorbent assay. Conjunctival blood-flow sludging was present in 92% of our patients, and cotton-wool spots were observed in 44%. Cotton-wool spots occurred only in patients with significant blood-flow sludging, and the quantity of cotton-wool spots was closely associated with blood-flow sludging (r = 0.64, P < 0.0001). Lower correlations were found between the numbers of cotton-wool spots and the serum level of neopterin (r = 0.40, P = 0.01) or the CD4+ count (r = -0.39, P = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Forschungsstelle für Experimentelle Ophthalmologie und Augenklinik, Universität Tübingen, Germany.
authors.forename: S A
authors.initials: SA
authors.lastname: Geier
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: F D
authors.initials: FD
authors.lastname: Goebel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001708:Biopterins / Q000031:analogs & derivatives / Q000032:analysis; D018791:CD4 Lymphocyte Count; D002448:Cell Adhesion; D005123:Eye / Q000098:blood supply*; D005128:Eye Diseases / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008833:Microcirculation; D019798:Neopterin; D011446:Prospective Studies; D013577:Syndrome; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D006454:Hemoglobins; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin