title: Objective analysis of retinal damage in HIV-positive patients in the HAART era using OCT.
abstract: OBJECTIVE
  To assess retinal nerve fiber layer (RNFL) thickness in patients with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis (CMV).
  
  
  METHODS
  A case-control study.
  
  
  METHODS
  The study included 113 eyes of 65 patients in one center. Thickness of RNFL along a 3.4-mm-diameter circle centered on the optic nerve head was evaluated using third-generation optical coherence tomography. Patients in group A (39 eyes of 22 patients) were human immunodeficiency virus-negative control subjects. Group B (36 eyes of 18 patients) was composed of HIV patients with no history of CMV retinitis and CD4 counts consistently above 100. Group C (38 eyes of 25 patients) comprised HIV patients with no history of CMV retinitis but a history of CD4 count less than 100 at some point lasting for at least 6 months.
  
  
  RESULTS
  The average RNFL thicknesses in groups A, B, and C were 103.33 +/- 8.50 microm, 103.30 +/- 9.28 microm, and 90.10 +/- 12.50 microm, respectively. Group C had significantly thinner overall RNFL than either of the groups A and B (Tukey-Kramer). This difference was most prominent in temporal, superior, and inferior retinal areas. No difference was in nasal retinal area, nor between groups A and B in any of the areas.
  
  
  CONCLUSIONS
  Significant RNFL thinning occurs in HIV patients without CMV retinitis and with low CD4 counts compared with the same subgroup of patients with CD4 count increased to above 100 and HIV-negative control subjects. Third-generation OCT may be useful in diagnosis of early subclinical HIV-associated visual functional loss.
authors.affiliation: Jacobs Retina Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California 92037, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Kozak
authors.forename: Dirk-Uwe
authors.initials: DU
authors.lastname: Bartsch
authors.forename: Lingyun
authors.initials: L
authors.lastname: Cheng
authors.forename: Brian R
authors.initials: BR
authors.lastname: Kosobucki
authors.forename: William R
authors.initials: WR
authors.lastname: Freeman
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity
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