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Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

Arcinue CA, Bartsch DU, El-Emam SY, Ma F, Doede A, Sharpsten L, Gomez ML, Freeman WR - PLoS ONE (2015)

Bottom Line: In each of the regions of interest studied (nasal, temporal, superior, inferior), the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2).We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer) was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls.

View Article: PubMed Central - PubMed

Affiliation: Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego (UCSD), La Jolla, California, United States of America.

ABSTRACT

Purpose: To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula) compared with age-matched HIV-negative controls.

Methods: Cohort of patients with known HIV under CART (combination Antiretroviral Therapy) treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT) to assess retinal layers and retinal thickness.

Results: Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative) were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior), the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2). A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative) was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea). We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer) was also significantly thickened in all the different locations scanned compared with HIV-negative controls.

Conclusion: Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

No MeSH data available.


Related in: MedlinePlus

Color fundus photo with boxed areas showing the different locations of the fovea and perifoveal areas that were scanned using the adaptive optics camera with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians.
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pone.0132996.g001: Color fundus photo with boxed areas showing the different locations of the fovea and perifoveal areas that were scanned using the adaptive optics camera with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians.

Mentions: All the study eyes were dilated for the AO exam. Twelve eyes of 6 patients in each group were examined. Each image was obtained from an average of 40 frames of a 4° x 4° retinal area over an acquisition time of 4 seconds. The patient was asked to keep good fixation on the intersection of the crossed lines. Multiple images of different locations of the fovea and perifoveal areas were scanned with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians (Fig 1), as follows: 2° nasal/0° vertical, 2° temporal/0° vertical, 2° superior/0° horizontal, 2° inferior/0° horizontal. The AO camera was carefully focused through the depth of the retina to detect the highest reflectivity consistent with the cone inner segments.


Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

Arcinue CA, Bartsch DU, El-Emam SY, Ma F, Doede A, Sharpsten L, Gomez ML, Freeman WR - PLoS ONE (2015)

Color fundus photo with boxed areas showing the different locations of the fovea and perifoveal areas that were scanned using the adaptive optics camera with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526563&req=5

pone.0132996.g001: Color fundus photo with boxed areas showing the different locations of the fovea and perifoveal areas that were scanned using the adaptive optics camera with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians.
Mentions: All the study eyes were dilated for the AO exam. Twelve eyes of 6 patients in each group were examined. Each image was obtained from an average of 40 frames of a 4° x 4° retinal area over an acquisition time of 4 seconds. The patient was asked to keep good fixation on the intersection of the crossed lines. Multiple images of different locations of the fovea and perifoveal areas were scanned with the patient fixating between 0 degrees and 2 degrees of retinal eccentricity from the foveal center along the horizontal and vertical meridians (Fig 1), as follows: 2° nasal/0° vertical, 2° temporal/0° vertical, 2° superior/0° horizontal, 2° inferior/0° horizontal. The AO camera was carefully focused through the depth of the retina to detect the highest reflectivity consistent with the cone inner segments.

Bottom Line: In each of the regions of interest studied (nasal, temporal, superior, inferior), the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2).We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer) was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls.

View Article: PubMed Central - PubMed

Affiliation: Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego (UCSD), La Jolla, California, United States of America.

ABSTRACT

Purpose: To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula) compared with age-matched HIV-negative controls.

Methods: Cohort of patients with known HIV under CART (combination Antiretroviral Therapy) treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT) to assess retinal layers and retinal thickness.

Results: Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative) were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior), the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2). A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative) was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea). We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer) was also significantly thickened in all the different locations scanned compared with HIV-negative controls.

Conclusion: Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

No MeSH data available.


Related in: MedlinePlus