Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey.
Retina. 2019 Jul;39(7):1416-1423. doi: 10.1097/IAE.0000000000002146.
To evaluate choroidal, macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses and retinal vascular caliber alterations in HIV-1-infected patients without opportunistic infections.
This cross-sectional study included 45 HIV-1-infected patients and 47 healthy subjects. Spectral domain optical coherence tomography was used for assessment of choroidal, macular, peripapillary RNFL thicknesses and retinal vascular caliber alterations.
The mean CD4 count was 426 ± 226 cells per milliliter and the mean HIV-1 RNA level was 1.8 × 10 ± 3.6 × 10 copies/mL in HIV-infected group. Central inner plexiform, superior photoreceptor, superior and nasal retinal pigment epithelium layers were thinner in HIV-infected patients compared with control subjects (P < 0.05). The differences in sectoral retinal thicknesses lost their significance after Bonferroni correction (P < 0.01). The average thickness of pericentral retina within 3 mm was thinner in the photoreceptor layer in HIV-infected patients compared with control subjects (P = 0.033). The differences in peripapillary RNFL thickness, choroidal thickness, and retinal vascular caliber were not significant between the groups. Choroidal thickness and pericentral outer plexiform were thinner, whereas peripapillary RNFL was thicker in newly diagnosed cases (16 patients) compared with patients having treatment for at least 4 months or longer (27 patients, P < 0.05, Mann-Whitney U test). HIV-1 RNA showed negative correlation with choroidal thickness (r = -0.435, P = 0.003) and positive correlation with peripapillary RNFL in central (r = 0.323, P = 0.032) and superonasal (r = 0.369, P = 0.014) sectors.
Choroidal thickness was thinner in newly diagnosed patients compared with patients on treatment. Viral load showed negative correlation with choroidal thickness. Retinal segmental alterations occurred in HIV-infected patients compared with control subjects.
评估无机会性感染的 HIV-1 感染者的脉络膜、黄斑、视盘周围视网膜神经纤维层（RNFL）厚度和视网膜血管口径改变。
本横断面研究纳入了 45 例 HIV-1 感染者和 47 例健康对照者。采用频域光学相干断层扫描评估脉络膜、黄斑、视盘周围 RNFL 厚度和视网膜血管口径改变。
HIV 感染者的平均 CD4 计数为 426 ± 226 个/毫升，平均 HIV-1 RNA 水平为 1.8×10 ± 3.6×10 拷贝/毫升。与对照组相比，HIV 感染者的中央内丛状层、上感光细胞层、上和鼻视网膜色素上皮层较薄（P < 0.05）。经 Bonferroni 校正后，各视网膜节段厚度的差异失去统计学意义（P < 0.01）。HIV 感染者感光细胞层中心 3mm 内的视网膜平均厚度较对照组薄（P = 0.033）。两组间视盘周围 RNFL 厚度、脉络膜厚度和视网膜血管口径无显著差异。与治疗至少 4 个月或更长时间的患者（27 例）相比，新诊断患者（16 例）的脉络膜厚度和中心旁外丛状层较薄，而视盘周围 RNFL 较厚（P < 0.05，Mann-Whitney U 检验）。HIV-1 RNA 与脉络膜厚度呈负相关（r = -0.435，P = 0.003），与中央（r = 0.323，P = 0.032）和超鼻侧（r = 0.369，P = 0.014）视盘周围 RNFL 呈正相关。
与治疗中的患者相比，新诊断患者的脉络膜厚度较薄。病毒载量与脉络膜厚度呈负相关。与对照组相比，HIV 感染者的视网膜节段出现改变。
