TY - JOUR
T1 - Retinal vessel caliber among people with acquired immunodeficiency syndrome
T2 - Relationships with visual function
AU - Kalyani, Partho S.
AU - Fawzi, Amani A.
AU - Gangaputra, Sapna
AU - Van Natta, Mark L.
AU - Hubbard, Larry D.
AU - Danis, Ronald P.
AU - Thorne, Jennifer E.
AU - Holland, Gary N.
N1 - Funding Information:
Publication of this article was supported by the Longitudinal Studies of the Ocular Complications of AIDS (LSOCA) grant support from the National Eye Institute , Bethesda, Maryland to the Mount Sinai School of Medicine, New York, New York ( U10 EY 08052 ); the Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland ( U10 EY 08057 ); and the University of Wisconsin, Madison , Madison, Wisconsin ( U10 EY 08067 ). Additional support provided by National Center for Research Resources through General Clinical Research Center Grants 5M01 RR 00350 ( Baylor College of Medicine , Houston, Texas), 5M01 RR 05096 ( Louisiana State University , Baton Rouge, Louisiana/Tulane/Charity Hospital, New Orleans, Louisiana), 5M01 RR00096 ( New York University Medical Center , New York, New York), 5M01 RR 00865 ( University of California , Los Angeles, California), 5M01 RR00046 ( University of North Carolina , Chapel Hill, North Carolina), 5M01 RR00043 ( University of Southern California , Los Angeles, California), and ULI RR024996 ( Weill Medical College of Cornell University , Ithaca, New York). Support also was provided through cooperative agreements U01 AI 27674 ( Louisiana State University/Tulane ), U01 AI 27660 ( University of California, Los Angeles ), U01 AI 27670 ( University of California, San Diego , California), U01 AI 27663 ( University of California, San Francisco , California), U01 AI25868 ( University of North Carolina ), and U01 AI32783 ( University of Pennsylvania, Philadelphia , Pennsylvania). Additional support was provided by the Skirball Foundation, New York, New York (Dr Holland); The Elizabeth Taylor AIDS Foundation through a gift to the UCLA Herb Ritts, Jr Memorial Vision Fund (Dr Holland); the Jack H. Skirball Endowed Professorship (Dr Holland); the Vernon O. Underwood Family Endowed Fellowship (Dr Kalyani); and the Sybil Harrington Special Scholars Award from Research to Prevent Blindness, Inc, New York, New York (Dr Thorne). None of the authors have conflicts of interest with any aspect of this study. Funding entities had no role in the conduction or presentation of this study. Involved in study design (P.S.K., A.A.F., M.L.V.N., G.N.H.); data collection (S.G., L.D.H., R.P.D., and the SOCA Research Group); data management and analysis (P.S.K., A.A.F., S.G., M.L.V.N., L.D.H., R.P.D., G.N.H.); data interpretation (P.S.K., A.A.F., S.G., M.L.V.N., L.D.H., R.P.D., J.E.T., G.N.H.); preparation of initial draft of manuscript (P.S.K., A.A.F., M.L.V.N., G.N.H.); and review and approval of manuscript (all authors, as well as Study Officers of LSOCA, representing the SOCA Research Group, reviewed and approved the manuscript). The study was conducted with approval from the appropriate institutional review boards at each participating institution. Informed consent was obtained from all subjects, and the study was conducted in accordance with Health Insurance Portability and Accountability Act regulations.
PY - 2012/3
Y1 - 2012/3
N2 - • Purpose: To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS. • Design: Longitudinal, observational cohort study. • Methods: We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Field Analyzer), and contrast sensitivity (CS) testing. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, sought independent relationships between indices and visual function variables. • Results: Included were 1250 participants. Smaller AVR was associated with reduced visual field by Goldmann perimetry (P =.003) and worse mean deviation (P =.02) on automated perimetry and possibly with worse pattern standard deviation (PSD) on automated perimetry (P =.06). There was a weak association between smaller AVR and worse CS (P =.07). Relationships were independent of antiretroviral therapy and level of immunodeficiency (CD4+ T lymphocyte count, human immunodeficiency virus [HIV] RNA blood level). On longitudinal analysis, retinal vascular indices at baseline did not predict changes in visual function. • Conclusions: Variation in retinal vascular indices is associated with abnormal visual function in people with AIDS, manifested by visual field loss and possibly by reduced CS. Relationships are consistent with the hypothesis that HIV-related retinal vasculopathy is a contributing factor to vision dysfunction among HIV-infected individuals. Longitudinal studies are needed to determine whether changes in indices predict change in visual function.
AB - • Purpose: To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS. • Design: Longitudinal, observational cohort study. • Methods: We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Field Analyzer), and contrast sensitivity (CS) testing. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, sought independent relationships between indices and visual function variables. • Results: Included were 1250 participants. Smaller AVR was associated with reduced visual field by Goldmann perimetry (P =.003) and worse mean deviation (P =.02) on automated perimetry and possibly with worse pattern standard deviation (PSD) on automated perimetry (P =.06). There was a weak association between smaller AVR and worse CS (P =.07). Relationships were independent of antiretroviral therapy and level of immunodeficiency (CD4+ T lymphocyte count, human immunodeficiency virus [HIV] RNA blood level). On longitudinal analysis, retinal vascular indices at baseline did not predict changes in visual function. • Conclusions: Variation in retinal vascular indices is associated with abnormal visual function in people with AIDS, manifested by visual field loss and possibly by reduced CS. Relationships are consistent with the hypothesis that HIV-related retinal vasculopathy is a contributing factor to vision dysfunction among HIV-infected individuals. Longitudinal studies are needed to determine whether changes in indices predict change in visual function.
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U2 - 10.1016/j.ajo.2011.08.027
DO - 10.1016/j.ajo.2011.08.027
M3 - Article
C2 - 22019221
AN - SCOPUS:84857454218
SN - 0002-9394
VL - 153
SP - 428-433.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 3
ER -