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Eye Health and Vision Function in Adults Aging with Well-Controlled HIV.

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Aging adults living with HIV (PLWH) show higher rates of vision impairment, particularly cataracts and dry eye disease, compared to people without HIV (PWOH). This highlights the ongoing need for comprehensive eye care in this population.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Gerontology

Background:

  • Aging adults living with HIV (PLWH) require ongoing monitoring for age-related health conditions.
  • Vision health is a critical component of quality of life in older adults.
  • Understanding vision health disparities in PLWH is essential for targeted interventions.

Purpose of the Study:

  • To compare vision health and eye conditions between aging adults living with HIV (PLWH) and comparable people without HIV (PWOH).
  • To assess the prevalence of visual impairment and specific eye pathologies in these groups.
  • To determine the need for eye care among virally suppressed PLWH and PWOH.

Main Methods:

  • Utilized data from the MACS/WIHS Combined Cohort Study (MWCCS).
  • Recruited PLWH and PWOH aged 60+ from Baltimore/Washington, DC (Sept 2021-Sept 2023).
  • Employed exact matching and sample weights for age-balanced comparisons; assessed visual acuity, corrected visual acuity, contrast sensitivity, and eye pathology.

Main Results:

  • Distance visual acuity impairment was more prevalent in PLWH (4%) than PWOH (1%).
  • Uncorrected refractive error was higher in PLWH (15%) vs. PWOH (5%).
  • Dry eye disease signs were observed in 63% of PLWH and 51% of PWOH; cataracts were present in ~50% of PLWH vs. 20% of PWOH. Glaucomatous changes were noted in 19% of PLWH and 25% of PWOH.

Conclusions:

  • Aging PLWH, even with viral suppression, experience a higher burden of certain vision impairments, including cataracts and dry eye disease, compared to their HIV-negative peers.
  • The findings underscore a significant need for regular, comprehensive eye examinations and tailored eyecare interventions for aging PLWH.
  • Continued research is warranted to explore the underlying mechanisms and effective management strategies for vision health in this growing population.