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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

Postprocessing of Adaptive Optics Images.A. HIV-positive, and B. Age-matched control, with scan centered on the fovea (fixation at 0 deg). Selected region of interest (ROI) (small yellow box). ROI magnified with corresponding color map of the cone density. Photoreceptor density counts shown.
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pone.0132996.g002: Postprocessing of Adaptive Optics Images.A. HIV-positive, and B. Age-matched control, with scan centered on the fovea (fixation at 0 deg). Selected region of interest (ROI) (small yellow box). ROI magnified with corresponding color map of the cone density. Photoreceptor density counts shown.

Mentions: Each series of 40 images acquired by the AO camera was processed using original software programs, provided by the manufacturer (CK v0.1 and AOdetect v0.1, Imagine Eyes). These images were registered and averaged to produce a final image with improved signal-to-noise ratio. The histogram of the resulting averaged image was stretched over a 16-bit range of gray levels for display purposes. The positions of photoreceptor inner segments were computed by automatically detecting the central coordinates of small circular spots whose brightness differed from the surrounding background level. The spatial distribution of these point coordinates was finally analyzed in terms of local cell numerical density (cells per square millimeter of retinal surface)[32]. For each patient, cone packing density analysis was performed on AO images within a range of 0.5° x 0.5° windows to 1° x 1° windows in the 4 regions of interest (ROI) (nasal, temporal, superior, inferior). Smaller ROI were chosen to avoid areas where the machine cannot count the cone photoreceptors, such as blood vessels. Each ROI chosen for each location (nasal, temporal, superior, inferior) was matched exactly to the same area in the eyes of the matched controls (Fig 2).


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)

Postprocessing of Adaptive Optics Images.A. HIV-positive, and B. Age-matched control, with scan centered on the fovea (fixation at 0 deg). Selected region of interest (ROI) (small yellow box). ROI magnified with corresponding color map of the cone density. Photoreceptor density counts shown.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4526563&req=5

pone.0132996.g002: Postprocessing of Adaptive Optics Images.A. HIV-positive, and B. Age-matched control, with scan centered on the fovea (fixation at 0 deg). Selected region of interest (ROI) (small yellow box). ROI magnified with corresponding color map of the cone density. Photoreceptor density counts shown.
Mentions: Each series of 40 images acquired by the AO camera was processed using original software programs, provided by the manufacturer (CK v0.1 and AOdetect v0.1, Imagine Eyes). These images were registered and averaged to produce a final image with improved signal-to-noise ratio. The histogram of the resulting averaged image was stretched over a 16-bit range of gray levels for display purposes. The positions of photoreceptor inner segments were computed by automatically detecting the central coordinates of small circular spots whose brightness differed from the surrounding background level. The spatial distribution of these point coordinates was finally analyzed in terms of local cell numerical density (cells per square millimeter of retinal surface)[32]. For each patient, cone packing density analysis was performed on AO images within a range of 0.5° x 0.5° windows to 1° x 1° windows in the 4 regions of interest (ROI) (nasal, temporal, superior, inferior). Smaller ROI were chosen to avoid areas where the machine cannot count the cone photoreceptors, such as blood vessels. Each ROI chosen for each location (nasal, temporal, superior, inferior) was matched exactly to the same area in the eyes of the matched controls (Fig 2).

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