title: Association between retinal nerve fiber layer thickness and abnormalities of vision in people with human immunodeficiency virus infection.
abstract: OBJECTIVE
  To investigate relationships between contrast sensitivity (CS), color vision, and retinal nerve fiber layer (RNFL) among people with human immunodeficiency virus (HIV) infection; to evaluate the effect of time since diagnosis of HIV infection on RNFL thickness.
  
  
  METHODS
  Noninterventional cross-sectional study.
  
  
  METHODS
  We evaluated 102 eyes of 57 HIV-infected individuals without ocular opportunistic infections. Peripapillary RNFL thickness was determined with spectral-domain optical coherence tomography in 4 quadrants. CS was measured with the Pelli-Robson technique (expressed as logCS); color vision was measured with the Lanthony desaturated 15-hue technique (expressed as color confusion index [C-index], with higher scores indicating worse color vision). Correlations between values were assessed using Spearman correlation coefficients.
  
  
  RESULTS
  Median RNFL thickness (average of 4 quadrants) was 102.9 μm (range, 75.0-134.7 μm). Median logCS was 1.90 (range, 1.25-1.95). Median C-index was 1.58 (range, 0.96-4.07). Temporal RNFL thickness was correlated with logCS (r=0.295, P=.003) and C-index (r=-0.338, P=.0005). Time since diagnosis of HIV infection was shorter for those with thick average RNFL than for those with thin average RNFL (P=.18).
  
  
  CONCLUSIONS
  Both worse CS and worse color vision are correlated with thinning of the temporal RNFL, with possible threshold effects. Increased prevalences of abnormal CS and abnormal color vision in this population are therefore likely attributable to neuroretinal compromise. This pattern of structural and functional losses may reflect preferential damage to small-caliber axons in the maculopapillary bundle, possibly associated with mitochondrial dysfunction, providing a potential disease mechanism for HIV-associated "neuroretinal disorder."
authors.affiliation: Ocular Inflammatory Disease Center, Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-7003, USA.
authors.forename: Partho S
authors.initials: PS
authors.lastname: Kalyani
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.forename: Amani A
authors.initials: AA
authors.lastname: Fawzi
authors.forename: Tiago E F
authors.initials: TE
authors.lastname: Arantes
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Alfredo A
authors.initials: AA
authors.lastname: Sadun
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001369:Axons / Q000473:pathology*; D018791:CD4 Lymphocyte Count; D003119:Color Perception Tests; D003117:Color Vision Defects / Q000175:diagnosis / Q000503:physiopathology*; D015350:Contrast Sensitivity / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000503:physiopathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000998:Antiviral Agents