Structural and Functional Assessment in HIV-Infected Patients Using Optical Coherence Tomography and Frequency-Doubling Technology Perimetry

Abstract

PURPOSE: To assess retinal nerve fiber layer (RNFL) and macular thickness using optical coherence tomography (OCT) on HIV-infected patients without ocular manifestations and to correlate these findings with frequency-doubling technology perimetry (FDT).DESIGN: Cross-sectional study.METHODS: SETTING: Single center. STUDY POPULATION: Seventy-three patients (146 eyes) with clinically normal examination classified in 3 groups: group A, HIV-infected patients with CD4 count 100 cells/mm(3) since diagnosis; and group C, HIV-negative control subjects. OBSERVATION PROCEDURES: Fast RNFL and fast macula scan strategies on Stratus OCT and Humphrey Matrix 24-2 full-threshold program. MAIN OUTCOME MEASURES: OCT RNFL and macular thicknesses and FDT indices (mean deviation [MD], pattern standard deviation [PSD], and glaucoma hemifield test [GHT]).RESULTS: Group A had a significantly thinner average RNFL, temporal outer macula, and inferior outer macula thicknesses when compared to groups B and C (P < .05). Statistically significant differences were observed in the FDT MD between groups A and C (P = .034) and in PSD in group A compared to groups B and C (P = .011). Eyes of HIV patients with GHT and PSD results outside normal confidence limits had thinner average RNFL thickness measures than eyes with results within normal limits in the same group of patients (P < .05).CONCLUSIONS: HIV-infected patients with low CD4 count have a significant RNFL and macular thinning. Functional loss detected by FDT is related to RNFL thinning in HIV-infected patients. (Am J Ophthalmol 2010;149: 571-576. (C) 2010 by Elsevier Inc. All rights reserved.)Universidade Federal de São Paulo, Dept Ophthalmol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ophthalmol, BR-04023062 São Paulo, BrazilWeb of ScienceCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES