Abstract
Purpose: To investigate the relationship between contrast sensitivity (CS) and mortality among people with acquired immunodeficiency syndrome (AIDS); and to explore the hypothesis that abnormal CS is a marker of systemic, life-threatening microvascular disease. Design: Longitudinal, observational cohort study. Methods: We evaluated 3395 eyes of 1706 individuals enrolled in the Longitudinal Study of the Complications of AIDS (1998-2008). CS was evaluated as a risk factor for death, and was compared to the presence of systemic diseases characterized by microvasculopathy (diabetes, cardiovascular disease, stroke, renal disease) and to laboratory markers of those diseases. Abnormal CS was defined as logCS <1.5 (lower 2.5th percentile for a normal control population). Results: CS was abnormal in 284 of 1691 (16.8%) study participants at enrollment. There was a positive relationship between the presence of abnormal CS at study entry and mortality (relative risk 2.0, 95% confidence interval 1.7-2.3, P < .0001). Abnormal CS was related to the presence of cardiovascular disease, stroke, and renal disease (all P values ≤ .01), but abnormal CS remained associated with death even after adjustment for these diseases and for other known predictors of death among people with AIDS. Diseases characterized by microvasculopathy were more often identified as causes of death among individuals with abnormal CS than among those with normal CS, although the strength of the association was moderate (P = .06). Conclusions: Abnormal CS among people with AIDS is associated with increased mortality, and is independent of other risk factors for death that are monitored routinely. The relationship may indicate life-threatening microvascular disease in other organs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 807-816 |
| Number of pages | 10 |
| Journal | American journal of ophthalmology |
| Volume | 149 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2010 |
Funding
This study was supported by cooperative agreements from the National Eye Institute, the National Institutes of Health , Bethesda, Maryland, to the Mount Sinai School of Medicine, New York, NY ( U10 EY08052 ), and the Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland ( U10 EY 08057 ). Additional support was provided by the National Center for Research Resources through General Clinical Research Center Grants 5M01 RR 00350 (Baylor College of Medicine, Houston, Texas), 5M01 RR 05096 (Louisiana State University, Baton Rouge, Louisiana/Tulane/Charity Hospital, New Orleans, Louisiana), 5M01 RR00096 (New York University Medical Center, New York, New York), 5M01 RR 00865 (University of California, Los Angeles, California), 5M01 RR00046 (University of North Carolina, Chapel Hill, North Carolina), 5M01 RR00043 (University of Southern California, Los Angeles, California), and ULI RR024996 (Weill Medical College of Cornell University, Ithaca, New York). Support also was provided through cooperative agreements U01 AI 27674 (Louisiana State University/Tulane), U01 AI 27660 (University of California, Los Angeles), U01 AI 27670 (University of California, San Diego, California), U01 AI 27663 (University of California, San Francisco, California), U01 AI25868 (University of North Carolina), and U01 AI32783 (University of Pennsylvania, Philadelphia, Pennsylvania). Additional support was provided by the Skirball Foundation , New York, New York (Dr Holland); The Elizabeth Taylor AIDS Foundation through a gift to the UCLA Herb Ritts, Jr Memorial Vision Fund (Dr Holland); and the Jack H. Skirball Endowed Professorship (Dr Holland).
ASJC Scopus subject areas
- Ophthalmology
