Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.
OBJECTIVE
To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS.


METHODS
Longitudinal, observational cohort study.


METHODS
We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Field Analyzer), and contrast sensitivity (CS) testing. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, sought independent relationships between indices and visual function variables.


RESULTS
Included were 1250 participants. Smaller AVR was associated with reduced visual field by Goldmann perimetry (P = .003) and worse mean deviation (P = .02) on automated perimetry and possibly with worse pattern standard deviation (PSD) on automated perimetry (P = .06). There was a weak association between smaller AVR and worse CS (P = .07). Relationships were independent of antiretroviral therapy and level of immunodeficiency (CD4+ T lymphocyte count, human immunodeficiency virus [HIV] RNA blood level). On longitudinal analysis, retinal vascular indices at baseline did not predict changes in visual function.


CONCLUSIONS
Variation in retinal vascular indices is associated with abnormal visual function in people with AIDS, manifested by visual field loss and possibly by reduced CS. Relationships are consistent with the hypothesis that HIV-related retinal vasculopathy is a contributing factor to vision dysfunction among HIV-infected individuals. Longitudinal studies are needed to determine whether changes in indices predict change in visual function.
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, California, USA.
Partho S
PS
Kalyani
Amani A
AA
Fawzi
Sapna
S
Gangaputra
Mark L
ML
van Natta
Larry D
LD
Hubbard
Ronald P
RP
Danis
Jennifer E
JE
Thorne
Gary N
GN
Holland
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015331:Cohort Studies; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012164:Retinal Diseases / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D012171:Retinal Vessels / Q000473:pathology*; D014786:Vision Disorders / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
D012367:RNA, Viral