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Brandão LN, Lira RPC, Arantes TEFE, Costa CCDM, Silva Neto EDD, Araújo PSRD, Bravo-Filho V. Comparison of Retinal Structure Using Optical Coherence Tomography Angiography between Persons with and without HIV Infection. Ocul Immunol Inflamm 2024; 32:550-555. [PMID: 36881580 DOI: 10.1080/09273948.2023.2175696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 03/08/2023]
Abstract
HIV retinal microangiopathy is an important predictor for increased risk of mortality. Optical coherence tomography angiography (OCTA) can investigate microvascular changes resulting from retinal diseases. Study included 25 persons with HIV and 25 healthy persons. OCTA evaluated the vascularization of retinal layers, choriocapillary, and optic disk. HIV group had lower vessel flow density (VFD) in superficial plexus. No difference was observed in the deep plexus. VFD of the optic disk and peripapillary region showed no difference between the groups. HIV group showed a thinner retinal nerve fiber layer and smaller area of the optic disk rim. HIV infection is associated with VFD reduction in superficial retinal plexus, neural rim area reduction, and retinal nerve fiber layer thinning in individuals without microangiopathic alterations on fundus examination. Therefore, OCTA can find retinal changes before clinical evidence of retinopathy.
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Affiliation(s)
- Luana Nogueira Brandão
- Medical School, Federal University of Alagoas, Arapiraca, Brazil
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil
- Medical School, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | | | - Vasco Bravo-Filho
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil
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Yaprak L, Çetinkaya Yaprak A, Sarigül F, Erkan Pota Ç, Ayan A. Comparison of retinochoroidal and optic nerve head microvascular circulation between HIV-positive patients and healthy subjects using optical coherence tomography angiography. J Fr Ophtalmol 2024; 47:104015. [PMID: 38129198 DOI: 10.1016/j.jfo.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To evaluate the retinal, choroidal, and optic disc head microvascular circulation in human immunodeficiency virus (HIV)-infected individuals without retinopathy receiving highly active antiretroviral therapy (HAART) using swept-source optical coherence tomography angiography (SS-OCTA). METHODS This cross-sectional study included 100 eyes of 100 patients with HIV infection but no HIV-related ocular disease and 108 eyes of 108 age- and sex-matched healthy subjects as the control group. SS-OCTA was used to assess foveal avascular zone (FAZ) area, retinal nerve fiber layer thickness (RNFL), choriocapillaris (CC) flow area, outer retinal (OR) thickness, radial peripapillary capillary (RPC) vessel density (VD), ONH VD, and choroidal thickness. RESULTS No statistically significant difference was found between the two groups except in the foveal VD of the deep capillary plexus (DCP). The foveal VD of the DCP was lower in the HIV-positive group (P=0.011). The mean FAZ area (mm2), perimeter (mm), and CC flow area (mm) values were higher in the HIV-positive group at statistically significant levels (P=0.021, P=0.02, and P=0.039, respectively). However, no statistically significant differences were found between the two groups concerning the OR flow area, subfoveal choroidal thickness, or the VDs of the RPC or ONH. CONCLUSIONS This is the first study in the literature to evaluate the microvascular circulation of the ONH in HIV-positive patients. Although retinal and choroidal microvascular circulation decreased in HIV-positive patients receiving HAART treatment, we found no effect on the microvascular circulation of the ONH or RPC microvascular circulation. Our findings suggest that retinochoroidal microvascular circulation is affected in HIV-positive patients over time.
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Affiliation(s)
- L Yaprak
- Department of Ophthalmology, Antalya and Research Hospital, Health Sciences University, Antalya, Turkey.
| | - A Çetinkaya Yaprak
- Department of Ophthalmology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - F Sarigül
- Department of Infectious Disease and Clinical Microbiology, Antalya Life Hospital, Antalya, Turkey
| | - Ç Erkan Pota
- Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey
| | - A Ayan
- Department of Rheumatologys, Antalya and Research Hospital, Health Sciences University, Antalya, Turkey
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van Genderen JG, Verkade CR, Van den Hof M, Demirkaya N, Schrantee AGM, Verbraak FD, Pajkrt D. Development of retinal structure in perinatally HIV-infected children and adolescents: A longitudinal and cross-sectional assessment. PLoS One 2023; 18:e0282284. [PMID: 36862721 PMCID: PMC9980730 DOI: 10.1371/journal.pone.0282284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/12/2023] [Indexed: 03/03/2023] Open
Abstract
In perinatally HIV-infected (PHIV) children, cross-sectional studies reported on subtle structural retinal differences and found associations between the retina and structural brain changes. Our objective is to investigate whether neuroretinal development in PHIV children is similar to the development in healthy matched controls and to explore associations with the brain structure. We measured RT using optical coherence tomography (OCT) on two occasions in 21 PHIV children or adolescents and 23 matched controls-all with good visual acuity-with a mean interval of 4.6 years (SD 0.3). We also included 22 participants (11 PHIV children and 11 controls) together with the follow-up group for a cross-sectional assessment using a different OCT device. Magnetic resonance imaging (MRI) was used to assess the white matter microstructure. We used linear (mixed) models to assess changes in RT and its determinants (over time), adjusting for age and sex. The development of the retina was similar between the PHIV adolescents and controls. In our cohort, we found that changes in the peripapillary RNFL was significantly associated with changes in WM microstructural makers: fractional anisotropy (coefficient = 0.030, p = 0.022) and radial diffusivity (coefficient = -0.568, p = 0.025). We found comparable RT between groups. A thinner pRNFL was associated with lower WM volume (coefficient = 0.117, p = 0.030). PHIV children or adolescents appear to have a similar development of the retinal structure. In our cohort, the associations between RT and MRI biomarkers underscore the relation between retina and brain.
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Affiliation(s)
- Jason G. van Genderen
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Charissa R. Verkade
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Malon Van den Hof
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Nazli Demirkaya
- Department of Ophthalmology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Anouk G. M. Schrantee
- Department of Radiology and Nuclear Medicine, Location Academic Medical Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Frank D. Verbraak
- Department of Ophthalmology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
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Du KF, Huang XJ, Chen C, Kong WJ, Xie LY, Dong HW, Wei WB. Macular Changes Observed on Optical Coherence Tomography Angiography in Patients Infected With Human Immunodeficiency Virus Without Infectious Retinopathy. Front Med (Lausanne) 2022; 9:820370. [PMID: 35462995 PMCID: PMC9021568 DOI: 10.3389/fmed.2022.820370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose As the human immunodeficiency virus (HIV) pandemic is far from over, whether there are subclinical macular changes in HIV-positive patients is something that should not be overlooked. We aimed to apply optical coherence tomography angiography (OCTA) to assess the macular structure and microvasculature changes in patients with HIV without infectious retinopathy. Methods HIV-positive and -negative participants were included and classified into three groups: HIV-negative, HIV-positive, and HIV-positive with microvasculopathy. OCTA parameters regarding macular structure and microvasculature were analyzed. Results Compared with the HIV-negative group, the superficial retinal vessel density (VD) in the parafovea sectors and the whole Early Treatment of Diabetic Retinopathy Study (ETDRS) grid and the choroidal vascularity index (CVI) in the whole ETDRS grid were significantly decreased in the HIV-positive and HIV-positive with microvasculopathy groups (p < 0.05). No differences were found in OCTA parameters between the HIV-positive and HIV-positive with microvasculopathy groups. Retinal, retinal nerve fiber layer-ganglion cell layer-inner plexiform layer (RNFL-GCL-IPL), RNFL, GCL-IPL, and INL thickness showed a negative association with the duration of HIV diagnosis or antiretroviral therapy (ART) (all p < 0.05). All OCTA microvasculature parameters showed no association with HIV-related clinical variables (all p > 0.05). Conclusions Subclinical macular changes existed in HIV-infected patients without clinical infectious retinopathy. Substructures from inner retinal layers might be associated with HIV infection or ART duration.
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Affiliation(s)
- Kui-Fang Du
- Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Jie Huang
- Department of Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Chao Chen
- Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen-Jun Kong
- Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Lian-Yong Xie
- Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hong-Wei Dong
- Department of Ophthalmology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Esen E, Sizmaz S, Kuscu F, Demircan C, Tasova Y, Unal I, Demircan N. Analysis of Macular Microvasculature in Human Immunodeficiency Virus Infection. Ocul Immunol Inflamm 2022; 31:728-733. [PMID: 35442846 DOI: 10.1080/09273948.2022.2056709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the retinal and choroidal microvascular blood flow in patients with human immunodeficiency virus (HIV) infection using optical coherence tomography angiography (OCTA). METHODS Macular OCTA parameters including vessel density (VD) of parafoveal superficial capillary plexus (SCP-VD) and deep capillary plexus (DCP-VD), foveal vessel density (FD), foveal avascular zone area, and flow area of choriocapillaris were analyzed in 42 HIV-positive patients, and compared with 42 healthy controls. RESULTS The mean SCP-VD, DCP-VD and FD were significantly lower in HIV-positive group compared with controls (p < .001, p = .014, p = .026; respectively). Reduced SCP-VD was associated with higher HIV RNA plasma level (r = -0.400, p = .021) and lower CD4 + T cell count (r = 0.314, p = .046) in HIV-positive patients. CONCLUSIONS Macular microvascular blood flow is affected by HIV infection. OCTA can detect microvascular flow abnormalities in retinal capillary plexus in HIV-positive patients.
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Affiliation(s)
- Ebru Esen
- Faculty of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey
| | - Selcuk Sizmaz
- Faculty of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey
| | - Ferit Kuscu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey
| | - Cansu Demircan
- Faculty of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey
| | - Yesim Tasova
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey
| | - Ilker Unal
- Faculty of Medicine, Department of Biostatistics, Cukurova University, Adana, Turkey
| | - Nihal Demircan
- Faculty of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey
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Collins LF, Shantha JG, Nesper PL, Sheth AN, Fawzi AA, Yeh S, Ofotokun I. Assessment of retinal microvascular health by optical coherence tomography angiography among persons with HIV. AIDS 2021; 35:1321-1324. [PMID: 33756509 PMCID: PMC8172530 DOI: 10.1097/qad.0000000000002890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Microvasculopathy may link HIV-related chronic inflammation and premature multimorbidity. In this proof-of-concept study, we used optical coherence tomography angiography (OCTA) to evaluate the retina as a convenient assessment of microvascular health among persons with HIV (PWH) undergoing surveillance ophthalmic care at Emory from 2018 to 2021. Among patients with longstanding HIV, OCTA identified microvascular abnormalities even among eyes without clinical retinal disease. Retinovascular evaluation by OCTA is a feasible, noninvasive technique for assessing microvasculopathy among PWH.
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Affiliation(s)
- Lauren F. Collins
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Grady Healthcare System, Infectious Diseases Program, Atlanta, Georgia
| | - Jessica G. Shantha
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA
| | - Peter L. Nesper
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anandi N. Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Grady Healthcare System, Infectious Diseases Program, Atlanta, Georgia
| | - Amani A. Fawzi
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Steven Yeh
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| | - Ighovwhera Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Grady Healthcare System, Infectious Diseases Program, Atlanta, Georgia
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Reduced macular vessel density in COVID-19 patients with and without associated thrombotic events using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2021; 259:2243-2249. [PMID: 33961108 PMCID: PMC8102150 DOI: 10.1007/s00417-021-05186-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/15/2021] [Accepted: 04/07/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose Thrombotic events (TE) represent one of the major complications of SARS-CoV-2 infection. The objective is to evaluate vessel density (VD) and perfusion density (PD) by optical coherence tomography angiography (OCTA) in COVID-19 patients, and compare the findings with healthy controls. The secondary objective is to evaluate if there are differences in OCTA parameters between COVID-19 patients with and without associated TE. Methods Cross-sectional case–control study that included patients with laboratory-confirmed diagnosis of COVID-19 with and without TE related to the infection and age-matched healthy controls. Ophthalmological examination and OCTA were performed 12 weeks after diagnosis. Demographic data and medical history were collected. Macular OCTA parameters in the superficial retinal plexus were analyzed according to ETDRS sectors. Results Ninety patients were included, 19 (20%) COVID-19 patients with associated TE, 47 (49.5%) COVID-19 patients without TE, and 29 (30.5%) healthy controls. Fifty-three (55.7%) were male, mean age 54.4 (SD 10.2) years. COVID-19 patients presented significantly lower VD than healthy controls: central (p = 0.003), inner ring (p = 0.026), outer ring (p = 0.001). PD was also significantly decreased: outer ring (p = 0.003), full area (p = 0.001). No differences in OCTA parameters were found between COVID-19 patients with and without TE. Conclusions OCTA represents a promising tool for the in vivo assessment of microvascular changes in COVID-19. Patients with SARS-CoV-2 infection show lower VD and PD compared to healthy controls. However, no differences were found between COVID-19 when considering TE. Prospective studies are required to further evaluate the retinal microvascular involvement of SARS-CoV-2 and its impact on the vasculature of other organs. Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05186-0.
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