Decreased macular leukocyte velocity in human immunodeficiency virus-infected individuals

PURPOSE: To determine whether human immunodeficiency virus (HIV)-infected i ndividuals have decreased macular capillary blood flow in vivo. DESIGN: Case control study. METHODS: Macular leukocyte velocity and perceived leukocyte density were de termined in 41 HIV-infected individuals without cytomegalovirus retinitis a nd 31 HIV-negative control subjects using the blue field simulation techniq ue (BFS-2000, Oculix, Inc., Jenkintown, PA). Velocity and density measureme nts for HIV,infected individuals were compared to current and lowest previo us CD4+ T-lymphocyte counts, HIV RNA blood levels, and blood leukocyte coun ts. RESULTS: Mean macular leukocyte velocity was lower in HIV-infected individu als than in controls (P = 0.0006). No correlations were identified between velocity measurements and the following factors in HIV-infected individuals : current or lowest previous CD4+ T-lymphocyte count; or HIV RNA blood leve l. Mean perceived leukocyte density in HIV-infected individuals was lower t han in controls (P = 0.003), but was not correlated with blood leukocyte co unt in HIV-infected individuals. No relationships were identified between m acular leukocyte velocity and duration of medication use or duration of ele vated CD4+ T-lymphocyte count in patients receiving potent antiretroviral t herapy. CONCLUSIONS: Reduced macular leukocyte velocity may have important implicat ions for understanding the retinal microvasculopathy of HIV disease, the pa thogenesis of opportunistic retinal infections, and visual dysfunction in H IV-infected individuals who do not have opportunistic retinal infections. W e found no evidence that macular leukocyte velocity increased with immune r econstitution. (C) 2001 by Elsevier Science Inc. All rights reserved.