Du Kui-Fang, Huang Xiao-Jie, Chen Chao, Kong Wen-Jun, Xie Lian-Yong, Dong Hong-Wei, Wei Wen-Bin
Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Department of Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Front Med (Lausanne). 2022 Apr 7;9:820370. doi: 10.3389/fmed.2022.820370. eCollection 2022.
As the human immunodeficiency virus (HIV) pandemic is far from over, whether there are subclinical macular changes in HIV-positive patients is something that should not be overlooked. We aimed to apply optical coherence tomography angiography (OCTA) to assess the macular structure and microvasculature changes in patients with HIV without infectious retinopathy.
HIV-positive and -negative participants were included and classified into three groups: HIV-negative, HIV-positive, and HIV-positive with microvasculopathy. OCTA parameters regarding macular structure and microvasculature were analyzed.
Compared with the HIV-negative group, the superficial retinal vessel density (VD) in the parafovea sectors and the whole Early Treatment of Diabetic Retinopathy Study (ETDRS) grid and the choroidal vascularity index (CVI) in the whole ETDRS grid were significantly decreased in the HIV-positive and HIV-positive with microvasculopathy groups ( < 0.05). No differences were found in OCTA parameters between the HIV-positive and HIV-positive with microvasculopathy groups. Retinal, retinal nerve fiber layer-ganglion cell layer-inner plexiform layer (RNFL-GCL-IPL), RNFL, GCL-IPL, and INL thickness showed a negative association with the duration of HIV diagnosis or antiretroviral therapy (ART) (all < 0.05). All OCTA microvasculature parameters showed no association with HIV-related clinical variables (all > 0.05).
Subclinical macular changes existed in HIV-infected patients without clinical infectious retinopathy. Substructures from inner retinal layers might be associated with HIV infection or ART duration.
由于人类免疫缺陷病毒（HIV）大流行远未结束，HIV阳性患者是否存在亚临床黄斑改变是一个不容忽视的问题。我们旨在应用光学相干断层扫描血管造影（OCTA）来评估无感染性视网膜病变的HIV患者的黄斑结构和微血管变化。
纳入HIV阳性和阴性参与者，并将其分为三组：HIV阴性组、HIV阳性组和伴有微血管病变的HIV阳性组。分析有关黄斑结构和微血管的OCTA参数。
与HIV阴性组相比，HIV阳性组和伴有微血管病变的HIV阳性组中，黄斑旁区域的浅表视网膜血管密度（VD）以及整个糖尿病视网膜病变早期治疗研究（ETDRS）网格的VD和整个ETDRS网格的脉络膜血管指数（CVI）均显著降低（P<0.05）。HIV阳性组和伴有微血管病变的HIV阳性组之间的OCTA参数未发现差异。视网膜、视网膜神经纤维层-神经节细胞层-内丛状层（RNFL-GCL-IPL）、RNFL、GCL-IPL和内核层（INL）厚度与HIV诊断或抗逆转录病毒治疗（ART）的持续时间呈负相关（均P<0.05）。所有OCTA微血管参数均与HIV相关临床变量无关联（均P>0.05）。
无临床感染性视网膜病变的HIV感染患者存在亚临床黄斑改变。视网膜内层的亚结构可能与HIV感染或ART持续时间有关。
