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通过光学相干断层扫描血管造影术评估无感染性视网膜病变的人类免疫缺陷病毒感染患者的黄斑和视盘变化。

Evaluation of macula and optic disc changes in human immunodeficiency virus-infected patients without infectious retinopathy by optical coherence tomography angiography.

作者信息

Bildirici Çağlar, Ozturk Mine, Tunçer Gülsah

机构信息

Department of Ophthalmology, Kütahya City Hospital, Kütahya, Turkey.

Department of Ophthalmology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

Indian J Ophthalmol. 2025 Jun 1;73(6):853-857. doi: 10.4103/IJO.IJO_3026_24. Epub 2025 May 28.

Abstract

PURPOSE

To detect early-stage changes in the macula, choroid, and optic disc with optic coherence tomography angiography (OCTA) in human immunodeficiency virus (HIV)-infected patients without retinitis.

DESIGN

Cross-sectional study.

METHODS

Twenty Turkish HIV-positive patients without retinitis and a control group of 20 healthy Turkish people were included in the study. CD4 T-cell counts and HIV RNA levels of the HIV-positive patient group were determined. Data were collected by performing OCTA following a complete ophthalmologic examination for all participants. The right eyes of all participants were included in the study.

RESULTS

The average CD4 T-cell count was 688 ± 198/mm3, the median value of the plasma HIV RNA count was 0 (0-27) copy/ml, and the mean disease duration was 5.65 ± 3.6 years in HIV-positive patients. In measurements made with OCTA, no significant difference was detected in retinal nerve fiber thickness, peripapillary capillary density, foveal density, superficial vascular density, deep vascular density, and foveal avascular zone in HIV-positive patients compared to the control group (P > 0.05). A moderate positive correlation was found between HIV infection duration and foveal density (r = 0.466, P = 0.002). Similarly, a moderate positive correlation was found between the duration of HIV infection and foveal thickness (r = 0.462, P = 0.003).

CONCLUSIONS

Except for the moderate positive correlation between duration of HIV infection and foveal density and foveal thickness, the absence of significant changes in OCTA may be explained by the high CD4 T-cell counts and low HIV RNA levels, indicating well-suppressed disease in our study. For more information on this subject, studies with large series and different HIV RNA and CD4 T-cell counts are needed.

摘要

目的

利用光学相干断层扫描血管造影(OCTA)检测未患视网膜炎的人类免疫缺陷病毒(HIV)感染患者黄斑、脉络膜和视盘的早期变化。

设计

横断面研究。

方法

本研究纳入了20名无视网膜炎的土耳其HIV阳性患者以及20名健康土耳其人组成的对照组。测定HIV阳性患者组的CD4 T细胞计数和HIV RNA水平。在对所有参与者进行全面眼科检查后,通过OCTA收集数据。所有参与者的右眼纳入研究。

结果

HIV阳性患者的平均CD4 T细胞计数为688±198/mm³,血浆HIV RNA计数的中位数为0(0 - 27)拷贝/ml,平均病程为5.65±3.6年。在用OCTA进行的测量中,与对照组相比,HIV阳性患者在视网膜神经纤维厚度、视乳头周围毛细血管密度、黄斑密度、浅层血管密度、深层血管密度和黄斑无血管区方面未检测到显著差异(P>0.05)。发现HIV感染持续时间与黄斑密度之间存在中度正相关(r = 0.466,P = 0.002)。同样,发现HIV感染持续时间与黄斑厚度之间存在中度正相关(r = 0.462,P = 0.003)。

结论

除了HIV感染持续时间与黄斑密度和黄斑厚度之间存在中度正相关外,OCTA未出现显著变化可能是由于CD4 T细胞计数高和HIV RNA水平低,表明我们研究中的疾病得到了良好控制。关于该主题的更多信息,需要进行更大样本量以及不同HIV RNA和CD4 T细胞计数的研究。

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本文引用的文献

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Comparison of Retinal Structure Using Optical Coherence Tomography Angiography between Persons with and without HIV Infection.
Ocul Immunol Inflamm. 2024 Jul;32(5):550-555. doi: 10.1080/09273948.2023.2175696. Epub 2023 Mar 7.
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