获得性免疫缺陷综合征患者的视网膜血管口径：与视觉功能的关系。
Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.
机构信息
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, California, USA.
出版信息
Am J Ophthalmol. 2012 Mar;153(3):428-433.e1. doi: 10.1016/j.ajo.2011.08.027. Epub 2011 Oct 22.
PURPOSE
To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS.
DESIGN
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.
目的
评估艾滋病患者视网膜血管口径与视觉功能测试之间的关系。
设计
纵向观察性队列研究。
方法
我们评估了 1998 年至 2008 年期间眼部艾滋病机会性感染初始检查（基线）时无眼部机会性感染的参与者的数据。使用最佳矫正视力、Goldmann 视野计、自动视野计（Humphrey 视野分析仪）和对比敏感度（CS）测试评估视觉功能。对眼底照片（每只眼/参与者）进行半自动分级，以确定中央视网膜动脉等效（CRAE）、中央视网膜静脉等效（CRVE）和动静脉比（AVR）在基线时的情况。使用逐步向前选择的多元线性回归模型，寻求指标与视觉功能变量之间的独立关系。
结果
共纳入 1250 名参与者。较小的 AVR 与 Goldmann 视野计检测到的视野减小（P =.003）和自动视野计上的平均偏差减小（P =.02）以及自动视野计上的 PSD 可能变差（P =.06）有关。较小的 AVR 与 CS 较差之间存在弱相关性（P =.07）。这些关系独立于抗逆转录病毒疗法和免疫缺陷程度（CD4+T 淋巴细胞计数、人免疫缺陷病毒[HIV]RNA 血液水平）。纵向分析显示，基线时视网膜血管指数不能预测视觉功能的变化。
结论
视网膜血管指数的变化与艾滋病患者的异常视觉功能有关，表现为视野丧失，可能与 CS 降低有关。这些关系与 HIV 相关的视网膜血管病变是 HIV 感染者视力障碍的一个致病因素的假说一致。需要进行纵向研究，以确定指数的变化是否预测视觉功能的变化。
Zotero 插件