Ocular blood flow in patients infected with human immunodeficiency virus

PURPOSE: Alterations of ocular blood flow may play a role in the pathophysi ology of human immunodeficiency virus (HIV) related retinal microvasculopat hy. In this study ocular blood flow was investigated in patients with HIV i nfection. DESIGN: In a prospective, cross,sectional study ocular blood flow was measu red in 37 eyes of consecutive HIV-infected persons and compared with the da ta of age-matched healthy controls. This sample size was calculated based o n an ct-error of 0.5 and a beta -error of 0.8. METHODS: Macular white blood cell flow, fundus pulsation amplitude, and blo od flow velocities in the retrobulbar vessels were measured with blue field entoptic technique, laser interferometry, and Doppler sonography, respecti vely. Immunologic and ophthalmologic status was evaluated from each patient . RESULTS: Mean CD4+ cell count of the HIV-infected persons was 206.8 +/- 145 .6 cells/mm(3). In five patients HIV-related retinopathy was observed. A si gnificant reduction in leukocyte density was seen in HIV infected persons ( 82.2 +/- 23.4) as compared with the control group (102.0 +/- 28.4; P = .019 ). The resistive index in the central retinal artery was higher in HIV infe cted patients (0.77 +/- 0.05) as compared with the controls (0.74 +/- 0.04; P = .04). The other hemodynamic parameters were not different between grou ps. No correlation of flow parameters and CD4+ cell count or HIV-related re tinopathy was observed. CONCLUSIONS: Decreased macular leukocyte density was detected in HIV infect ed persons. Our study suggests that abnormal retinal hemodynamics in indivi duals infected with HIV may be involved in the pathogenesis of HIV-related microvasculopathy. (C) 2001 by Elsevier Science Inc. All rights reserved.