Structural and functional assessment in HIV-infected patients using optical coherence tomography and frequency-doubling technology perimetry.
OBJECTIVE
To assess retinal nerve fiber layer (RNFL) and macular thickness using optical coherence tomography (OCT) on HIV-infected patients without ocular manifestations and to correlate these findings with frequency-doubling technology perimetry (FDT).


METHODS
Cross-sectional study.


METHODS
setting: Single center. study population: Seventy-three patients (146 eyes) with clinically normal examination classified in 3 groups: group A, HIV-infected patients with CD4 count <100 cells/mm(3) for at least 6 months; group B, HIV-infected patients with CD4 count >100 cells/mm(3) since diagnosis; and group C, HIV-negative control subjects. observation procedures: Fast RNFL and fast macula scan strategies on Stratus OCT and Humphrey Matrix 24-2 full-threshold program. main outcome measures: OCT RNFL and macular thicknesses and FDT indices (mean deviation [MD], pattern standard deviation [PSD], and glaucoma hemifield test [GHT]).


RESULTS
Group A had a significantly thinner average RNFL, temporal outer macula, and inferior outer macula thicknesses when compared to groups B and C (P < .05). Statistically significant differences were observed in the FDT MD between groups A and C (P = .034) and in PSD in group A compared to groups B and C (P = .011). Eyes of HIV patients with GHT and PSD results outside normal confidence limits had thinner average RNFL thickness measures than eyes with results within normal limits in the same group of patients (P < .05).


CONCLUSIONS
HIV-infected patients with low CD4 count have a significant RNFL and macular thinning. Functional loss detected by FDT is related to RNFL thinning in HIV-infected patients.
Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. t.arantes@inbox.com
Tiago Eugênio
TE
Faria E Arantes
Claudio Renato
CR
Garcia
Paulo Augusto de Arruda
PA
Mello
Cristina
C
Muccioli
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003430:Cross-Sectional Studies; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D015497:HIV-1; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests