Evaluation of macula and optic disc changes in human immunodeficiency virus-infected patients without infectious retinopathy by optical coherence tomography angiography.

PURPOSE: To detect early-stage changes in the macula, choroid, and optic disc with optic coherence tomography angiography (OCTA) in human immunodeficiency virus (HIV)-infected patients without retinitis.

DESIGN

Cross-sectional study.

METHODS

Twenty Turkish HIV-positive patients without retinitis and a control group of 20 healthy Turkish people were included in the study. CD4 T-cell counts and HIV RNA levels of the HIV-positive patient group were determined. Data were collected by performing OCTA following a complete ophthalmologic examination for all participants. The right eyes of all participants were included in the study.

RESULTS

The average CD4 T-cell count was 688 ± 198/mm3, the median value of the plasma HIV RNA count was 0 (0-27) copy/ml, and the mean disease duration was 5.65 ± 3.6 years in HIV-positive patients. In measurements made with OCTA, no significant difference was detected in retinal nerve fiber thickness, peripapillary capillary density, foveal density, superficial vascular density, deep vascular density, and foveal avascular zone in HIV-positive patients compared to the control group (P > 0.05). A moderate positive correlation was found between HIV infection duration and foveal density (r = 0.466, P = 0.002). Similarly, a moderate positive correlation was found between the duration of HIV infection and foveal thickness (r = 0.462, P = 0.003).

CONCLUSIONS

Except for the moderate positive correlation between duration of HIV infection and foveal density and foveal thickness, the absence of significant changes in OCTA may be explained by the high CD4 T-cell counts and low HIV RNA levels, indicating well-suppressed disease in our study. For more information on this subject, studies with large series and different HIV RNA and CD4 T-cell counts are needed.