title: HIV-Associated Neuroretinal Disorder in Patients With Well-Suppressed HIV-Infection: A Comparative Cohort Study.
abstract: OBJECTIVE
  Loss of neuroretinal structure and function, ascribed to a 'HIV-associated Neuroretinal Disorder' (HIV-NRD), in the absence of ocular opportunistic infections, has been reported in HIV-infected individuals treated with combination antiretroviral therapy (cART). Whether HIV-infected individuals with prolonged well-suppressed infection remain at risk for HIV-NRD, is unknown.
  
  
  METHODS
  Ninety-two HIV-infected men with suppressed viremia on cART for at least 12 months (HIV+) and 63 HIV-uninfected, highly comparable, male controls (HIV-), aged at least 45 years, underwent functional measurements of spatial (Pelli Robson contrast sensitivity [PR CS]) and temporal contrast sensitivity (TCS) and straylight, as well as spectral-domain optical coherence tomography analysis measured total and individual retinal layer thickness. Mixed-linear regression models were used to assess possible associations between HIV-related and ocular parameters, while accounting for several confounders.
  
  
  RESULTS
  Pelli Robson CS was significantly lower in HIV+ (1.89 vs. 1.93 logCS, P value = 0.001), while TCS values did not differ (2.17 vs. 2.17 logCS; P value = 0.888). Straylight values were higher in HIV+ (1.15 vs. 1.09 log units; P value = 0.026). Peripheral total retinal thickness in the HIV+ group was increased compared with HIV- (+4.6 μm, P value = 0.029), predominantly due to an increase in inner nuclear layer (+1.04 μm, P value = 0.006) and outer plexiform layer (+0.95 μm, P value = 0.006) thickness.
  
  
  CONCLUSIONS
  Pelli Robson CS was significantly reduced in HIV-infected individuals, although the loss was one letter and likely not clinically relevant. Instead of an expected neuroretinal thinning, an increase of retinal thickness was detected in the HIV-infected group. These findings should be confirmed and further explored in longitudinal studies. Clinical Trial registered at www.clinicaltrials.gov (identifier: NCT01466582).
authors.affiliation: Department of Ophthalmology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nazli
authors.initials: N
authors.lastname: Demirkaya
authors.affiliation: Department of Global Health, Academic Medical Center and Amsterdam Institute for Global Health and Development, The Netherlands 3Division of Infectious Diseases and Center for Infection and Immunity Amsterdam (CINIMA), The Netherlands.
authors.forename: Ferdinand W N M
authors.initials: FW
authors.lastname: Wit
authors.affiliation: Netherlands Institute for Neuroscience, Royal Academy, Amsterdam, The Netherlands.
authors.forename: Thomas J T P
authors.initials: TJ
authors.lastname: van Den Berg
authors.affiliation: Department of Global Health, Academic Medical Center and Amsterdam Institute for Global Health and Development, The Netherlands.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Kooij
authors.affiliation: Division of Infectious Diseases and Center for Infection and Immunity Amsterdam (CINIMA), The Netherlands 5Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.affiliation: Department of Ophthalmology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands 4Netherlands Institute for Neuroscience, Royal Academy, Amsterdam, The Netherlands.
authors.forename: Reinier O
authors.initials: RO
authors.lastname: Schlingemann
authors.affiliation: Department of Ophthalmology and Visual Sciences, Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa City, Iowa, United States 7Department of Biomedical Engineering and Department of Electrical and Computer Engineering, University of I.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Abramoff
authors.affiliation: Department of Global Health, Academic Medical Center and Amsterdam Institute for Global Health and Development, The Netherlands 3Division of Infectious Diseases and Center for Infection and Immunity Amsterdam (CINIMA), The Netherlands 8The Netherlands HIV.
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.affiliation: Department of Ophthalmology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands 9Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands 10Department of Ophthalmology, VU University Medical Center.
authors.forename: Frank D
authors.initials: FD
authors.lastname: Verbraak
mesh_terms: D015350:Contrast Sensitivity; D005260:Female; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity