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Layer-by-layer macular, peripapillary retinal nerve fiber layer thickness and minimum rim width changes in PLWH with
Müge Toygar Deniz1, Büşra Yılmaz Tuğan2, Gözde Karaca3
1Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye.
Summary
People living with HIV show thinner retinas and optic nerves compared to healthy individuals, even when their viral load is suppressed. These changes are linked to HIV status, viral load, and disease duration, suggesting subclinical eye involvement.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Neuroscience
Background:
- HIV infection can affect various organ systems, including the eye.
- Ocular complications in people living with HIV (PLWH) can range from opportunistic infections to neuroretinal changes.
- Understanding subclinical retinal changes is crucial for early detection and management in PLWH.
Purpose of the Study:
- To compare macular thickness and optic nerve head parameters between virologically suppressed PLWH and healthy controls.
- To investigate the association between HIV status, viral load, disease duration, and retinal parameters.
Main Methods:
- Prospective cross-sectional study involving 94 eyes from PLWH and 80 eyes from healthy controls.
- Spectral-domain optical coherence tomography (SD-OCT) was used to assess layer-by-layer macular thickness, peripapillary retinal nerve fiber layer (RNFL), Bruch's membrane opening minimum rim width (BMO-MRW), and subfoveal choroidal thickness.
- Multivariable regression analyses and correlation analyses were performed to identify independent associations.
Main Results:
- PLWH exhibited significantly thinner macular parameters and subfoveal choroidal thickness compared to controls.
- Significant thinning was observed in the peripapillary RNFL and BMO-MRW in PLWH.
- HIV status remained independently associated with reduced retinal parameters after adjusting for confounders. Higher HIV RNA levels and longer disease duration correlated with greater inner retinal thinning.
Conclusions:
- Virologically suppressed PLWH demonstrate significant thinning of macular and peripapillary retinal layers and reduced choroidal thickness.
- These neuroretinal changes are independently associated with HIV status.
- Findings suggest subclinical neuroretinal involvement in HIV infection, highlighting the need for regular ophthalmological monitoring.
