Choroidal characteristics in HIV infection and their association with disease severity

Abstract

Aim: To evaluate choroidal characteristics in patients with Human Immunodeficiency Virus (HIV) using spectral-domain optical coherence tomography (SD-OCT), and assess their correlation with disease severity.

Method: Fifty-eight eyes from 29 HIV-positive patients and 62 eyes from 31 age and sex-matched healthy controls were included. Measurements of choroidal thickness (CT), total choroidal area (TCA), stromal area (SA), and luminal area (LA) were obtained via SD-OCT (Maestro, Topcon Co., Tokyo, Japan). The choroidal vascular index (CVI) was calculated using the binarization method. Disease duration, highly active antiretroviral therapy (HAART) duration, HIV-RNA, and CD4 T cell count at diagnosis and at the time of examination, and venereal disease research laboratory (VDRL) test results were recorded. Correlations between SD-OCT results and HIV parameters were analyzed.

Results: No significant differences in age or sex were observed between groups (p=0.988 and p=0.355, respectively). Although the HIV group had lower mean values for CT, TCA, LA, SA, and CVI than controls, these differences were not statistically significant (p=0.344, p=0.054, p=0.075, p=0.865, p=0.313, respectively). SA was inversely correlated with CD4 T cell counts (r = -0.477, p = 0.014). HAART duration was inversely correlated with CT (r=-0.376, p=0.044). VDRL positivity did not affect OCT parameters (p>0.05).

Conclusions: Choroidal structures were thinner in patients who had been on HAART for a longer duration compared to those who were newly diagnosed. Changes in choroidal substructures may be more closely associated with long-term HIV infection or HAART duration rather than HIV-RNA or CD4 T cell counts.