Purpose: To assess retinal nerve fiber layer (RNFL) thickness in patients with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis (CMV). Design: A casecontrol study. Methods: The study includ...Purpose: To assess retinal nerve fiber layer (RNFL) thickness in patients with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis (CMV). Design: A casecontrol study. Methods: The study included 113 eyes of 65 patients in one center. Thickness of RNFL along a 3.4- mmdiameter circle centered on the optic nerve head was evaluated using third- generation optical coherence tomography. Patients in group A (39 eyes of 22 patients) were human immunode- ficiency virus- negative control subjects. Group B (36 eyes of 18 patients) was composed of HIV patients with no history of CMVretinitis and CD4 counts consistently above 100. Group C (38 eyes of 25 patients) comprised HIV patients with no history of CMV retinitis but a history of CD4 count less than 100 at some point lasting for at least 6 months. Results: The average RNFL thicknesses in groups A, B, and C were 103.33± 8.50 μ m, 103.30± 9.28 μ m, and 90.10± 12.50 μ m, respectively. Group C had significantly thinner overall RNFL than either of the groups A and B (Tukey- Kramer). This difference was most prominent in temporal, superior, and inferior retinal areas. No differencewas in nasal retinal area, nor between groups A and B in any of the areas. Conclusions: Significant RNFL thinning occurs in HIV patients without CMV retinitis and with low CD4 counts compared with the same subgroup of patients with CD4 count increased to above 100 and HIV- negative control subjects. Third- generation OCT may be useful in diagnosis of early subclinicalHIV- associated visual functional loss.展开更多
Purpose: To characterize a longitudinal relationship between highly active antiretroviral therapy immune recovery as defined by an increase in CD4 cell counts and any associated changes in intraocular pressure (IOP) i...Purpose: To characterize a longitudinal relationship between highly active antiretroviral therapy immune recovery as defined by an increase in CD4 cell counts and any associated changes in intraocular pressure (IOP) in both patients with and patients without a history of cytomegalovirus (CMV) retinitis and to determine if human immunodeficiency (HIV)-induced reduction in IOP is reversible. Design: Retrospective analysis of patient data collected from 1997 through 2004. Participants: Cohort of patients from one eye center, including patients from the Longitudinal Study of Ocular Complications of Acquired Immunodeficiency Syndrome. Methods: Linear regression analyses were conducted within the CMV and non-CMV groups to determine the change in IOP per 100- unit change in CD4 count. Average changes in IOP per change in CD4 count were compared between the CMV and the non-CMV groups using a Wilcoxon rank-sum test. Linear regression analyses were conducted within the CMV and non-CMV groups to determine the linear relationship between the 12- month change in IOP per 12- month 100- unit change in CD4 count. Main Outcome Measure: Intraocular pressure in relation to changes inCD4 cell counts. Results: Compared with the non-CMV group, the median IOP change per change in CD4 count was not statistically different from the CMV group (0.9 vs. 1.7 mmHg/100 CD4 cells, respectively; P=0.20). Analysis of the linear relationship between the 12- month change in IOP and the 12- month change in CD4 count within both the CMV and non-CMV groups showed a strong linear relationship: 67% of the variability in a 12- month IOP change for the CMV group (P<0.0001) and 36% of the variability in a 12- month IOP change for the non-CMV group (P<0.001). Conclusions: Reduction in T-lymphocyte count in HIV infection is accompanied by a decrease in IOP in both CMV-infected and non-CMV-infected eyes, and immune recovery is associated with an increase in IOP.展开更多
文摘Purpose: To assess retinal nerve fiber layer (RNFL) thickness in patients with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis (CMV). Design: A casecontrol study. Methods: The study included 113 eyes of 65 patients in one center. Thickness of RNFL along a 3.4- mmdiameter circle centered on the optic nerve head was evaluated using third- generation optical coherence tomography. Patients in group A (39 eyes of 22 patients) were human immunode- ficiency virus- negative control subjects. Group B (36 eyes of 18 patients) was composed of HIV patients with no history of CMVretinitis and CD4 counts consistently above 100. Group C (38 eyes of 25 patients) comprised HIV patients with no history of CMV retinitis but a history of CD4 count less than 100 at some point lasting for at least 6 months. Results: The average RNFL thicknesses in groups A, B, and C were 103.33± 8.50 μ m, 103.30± 9.28 μ m, and 90.10± 12.50 μ m, respectively. Group C had significantly thinner overall RNFL than either of the groups A and B (Tukey- Kramer). This difference was most prominent in temporal, superior, and inferior retinal areas. No differencewas in nasal retinal area, nor between groups A and B in any of the areas. Conclusions: Significant RNFL thinning occurs in HIV patients without CMV retinitis and with low CD4 counts compared with the same subgroup of patients with CD4 count increased to above 100 and HIV- negative control subjects. Third- generation OCT may be useful in diagnosis of early subclinicalHIV- associated visual functional loss.
文摘Purpose: To characterize a longitudinal relationship between highly active antiretroviral therapy immune recovery as defined by an increase in CD4 cell counts and any associated changes in intraocular pressure (IOP) in both patients with and patients without a history of cytomegalovirus (CMV) retinitis and to determine if human immunodeficiency (HIV)-induced reduction in IOP is reversible. Design: Retrospective analysis of patient data collected from 1997 through 2004. Participants: Cohort of patients from one eye center, including patients from the Longitudinal Study of Ocular Complications of Acquired Immunodeficiency Syndrome. Methods: Linear regression analyses were conducted within the CMV and non-CMV groups to determine the change in IOP per 100- unit change in CD4 count. Average changes in IOP per change in CD4 count were compared between the CMV and the non-CMV groups using a Wilcoxon rank-sum test. Linear regression analyses were conducted within the CMV and non-CMV groups to determine the linear relationship between the 12- month change in IOP per 12- month 100- unit change in CD4 count. Main Outcome Measure: Intraocular pressure in relation to changes inCD4 cell counts. Results: Compared with the non-CMV group, the median IOP change per change in CD4 count was not statistically different from the CMV group (0.9 vs. 1.7 mmHg/100 CD4 cells, respectively; P=0.20). Analysis of the linear relationship between the 12- month change in IOP and the 12- month change in CD4 count within both the CMV and non-CMV groups showed a strong linear relationship: 67% of the variability in a 12- month IOP change for the CMV group (P<0.0001) and 36% of the variability in a 12- month IOP change for the non-CMV group (P<0.001). Conclusions: Reduction in T-lymphocyte count in HIV infection is accompanied by a decrease in IOP in both CMV-infected and non-CMV-infected eyes, and immune recovery is associated with an increase in IOP.
