Laser Scanning Confocal Ophthalmoscopy and Polarimetry of Human Immunodeficiency Virus Patients Without Retinopathy, Under Antiretroviral Therapy

Abstract

HRT and GDx-VCC indicators of RNFL thickness appear to be significantly reduced in HIV-positive subjects without retinopathy or optic nerve disease using antiretroviral medication, suggesting RNFL loss occurs in this population of HIV-positive patients. The lack of correlation between CD4 counts, viral load, number of antiretroviral medications used, or years from diagnosis of HIV and RNFL thinning, suggests that possibly other factors associated with HIV infection may contribute to the apparent RNFL thickness loss.

Retinal Structure and Function in Perinatally HIV-Infected and cART-Treated Children: A Matched Case–Control Study

“…This study aimed to assess retinal structure and visual function in a group of perinatally HIV-infected children, compared to a group of matched healthy controls. Subtle structural retinal changes and visual dysfunction, termed HIVassociated neuroretinal disorder, have been described in HIVinfected adults on cART without infectious retinitis [1][2][3][4][5][6][7][8][9][10]14,16,17,[51][52][53][54][55][56][57][58][59] ; however, data on this subject in HIVinfected children are limited and derived from one study group. 22,23 This is the first study assessing individual retinal layer thicknesses and exploring associations between various HIV-and cART-related factors and ocular parameters in HIVinfected children.…”

“…1,7,9 Multiple adult studies indeed reported a decrease in peripapillary RNFL thickness, particularly in patients with (a histor y of) low (<100 cells/mm 3 ) CD4 þ T-cell counts. 4,52,[57][58][59] Since the axons of the ganglion cell layer make up the optic nerve in large part, a decrease in peripapillary RNFL implies that a decrease in ganglion cell layer thickness (and possibly other inner retinal layers) would also be expected, but no study has reported on this. If we extrapolate this hypothesis of HIV-associated neuroretinal degeneration to HIV-infected children, a decrease of peripapillary RNFL thickness and inner retinal layers (especially in the pericentral retinal area, where the ganglion cell layer is thickest) would be expected in this group.…”

Relationship Between Retinal Nerve Fiber Layer and Visual Field Function in Human Immunodeficiency Virus–infected Patients Without Retinitis

“…6 It is hypothesized that damage to the inner retina caused by retinovascular abnormalities, including retinal cotton wool spots, leads to permanent impairment of the ganglion cell layer and RNFL with consequent visual function deterioration. [1][2][3][4][5]7,8 A strong spatial correlation has been observed between peripapillary RNFL damage measured by OCT and VF sensitivity in glaucoma. [9][10][11][12] This relationship has also been observed in other optic neuropathies, including compressive 13,14 and ischemic optic neuropathies.…”

Pattern recognition can detect subtle field defects in eyes of HIV individuals without retinitis under HAART

“…Inner retinal thinning was previously reported with OCT and scanning laser polarimetry of low CD4 eyes, with inferior thinning being more prominent [12, 13]. RNFL thinning was found even in patients with good immune status in the HAART era [35]. Retinal microinfarctions may be responsible for the RNFL defects and field deficits.…”