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(Investigative Ophthalmology and Visual Science. 2006;47:3933-3938.)
© 2006 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.06-0138
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Hemorheologic Abnormalities Associated with HIV Infection: In Vivo Assessment of Retinal Microvascular Blood Flow

Hajir Dadgostar,1,2 Gary N. Holland,1,2,3 Xin Huang,4 Adnan Tufail,1,2 Alisa Kim,1,2 Timothy C. Fisher,5 William G. Cumberland,3,4 Herbert J. Meiselman,5 Arthur Benjamin,1,2 and Dirk-Uwe Bartsch6

1From the Ocular Inflammatory Disease Center, Jules Stein Eye Institute and the 2Department of Ophthalmology, David Geffen School of Medicine at UCLA, the 3UCLA AIDS Institute and the 4Department of Biostatistics, UCLA School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California; the 5Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California; and the 6Department of Ophthalmology, University of California, San Diego School of Medicine, San Diego, California.

PURPOSE. To evaluate retinal microvascular blood flow in human immunodeficiency virus (HIV)–infected individuals using scanning laser Doppler flowmetry (SLDF) and to seek correlations between flow and various laboratory measures that may predict alterations in flow.

METHODS. The Heidelberg Retina Flowmeter and SLDF software were used to acquire in vivo retinal blood flow data from 24 HIV-infected individuals and 16 HIV-negative control subjects. In each subject, separate scans were performed in each of six retinal regions: nasal parapapillary retina; macula; and the superior, nasal, inferior, and temporal periphery. Erythrocyte aggregation (assessed in vitro by a fully automatic erythrocyte aggregometer and by zeta sedimentation ratio [ZSR, a hematocrit-independent sedimentation rate]), serum fibrinogen level, plasma viscosity, and leukocyte rigidity (assessed in vitro with a cell transit analyzer) were compared with flow in selected regions.

RESULTS. Flow was significantly higher in the periphery (superior, nasal, inferior, temporal) than in the posterior retina (nasal parapapillary retina, macula). Flow was highest in the temporal periphery for both HIV-infected subjects and control subjects. Flow in the posterior retina was significantly lower in HIV-infected subjects than in control subjects (P < 0.0001). Among HIV-infected individuals, flow in the macula correlated negatively with ZSR (r = –0.397, P = 0.0547) and leukocyte rigidity (r = –0.505, P = 0.0119).

CONCLUSIONS. Microvascular blood flow in the posterior retina is reduced in HIV-infected individuals. Both increased erythrocyte aggregation and increased leukocyte rigidity contribute to this hemorheologic abnormality.






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