@article{7d7f1f4b7ab04a659344d0cc642b6b78,
title = "Retinal vessel caliber among people with acquired immunodeficiency syndrome: Relationships with disease-associated factors and mortality",
abstract = "• Purpose: To evaluate relationships between retinal vessel caliber, AIDS-related factors, and mortality. • Design: Longitudinal, observational cohort study. • Methods: We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (19982008). Semi-automated evaluation of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, identified independent relationships between indices and various host- and disease-related variables. • Results: Included were 1250 participants. Mean follow-up for determination of mortality was 6.1 years. Smaller CRAE was related to increased age (P <.001) and hypertension (P <.001); larger CRAE was related to lower hematocrit (P =.002). Larger CRAE and CRVE were associated with black race (P <.001). Larger CRVE was related to smoking (P =.004); smaller CRVE was related to age (P <.001) and higher mean corpuscular volume (P =.001). We observed the following relationships with AIDS-associated factors: smaller CRAE and larger CRVE with history of highly active antiretroviral therapy (HAART; P <.001); and larger CRAE with lower CD4+ T lymphocyte count (P =.04). We did not identify independent relationships with human immunodeficiency virus RNA blood levels. There was a 12% (95% CI, 2%21%) increase in mortality risk per quartile of decreasing AVR (P =.02). • Conclusions: Variations in retinal vascular caliber are associated with AIDS-specific factors and are markers for increased mortality risk. Relationships are consistent with the hypothesis that the vasculature is altered by known atherogenic effects of chronic HAART or the prolonged inflammatory state associated with AIDS.",
author = "Sapna Gangaputra and Kalyani, {Partho S.} and Fawzi, {Amani A.} and {Van Natta}, {Mark L.} and Hubbard, {Larry D.} and Danis, {Ronald P.} and Thorne, {Jennifer E.} and Holland, {Gary N.}",
note = "Funding Information: Publication of this article was supported by Longitudinal Study of the Ocular Complications of AIDS (LSOCA) grant support from the National Eye Institute , Bethesda, Maryland to the Mount Sinai School of Medicine, New York, New York ( U10 EY 08052 ); the Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland ( U10 EY 08057 ); and the University of Wisconsin , Madison, Madison, Wisconsin ( U10 EY 08067 ). Additional support provided by 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); the Jack H. Skirball Endowed Professorship (Dr Holland); the Vernon O. Underwood Family Endowed Fellowship (Dr Kalyani); and the Sybil Harrington Special Scholars Award from Research to Prevent Blindness, Inc, New York, New York (Dr Thorne). None of the authors have conflicts of interest with any aspect of this study. Funding entities had no role in the conduction or presentation of this study. Involved in study design (P.S.K., A.A.F., M.L.V.N., G.N.H.); data collection (S.G., L.D.H., R.P.D., and the SOCA Research Group); data management and analysis (S.G., P.S.K., A.A.F., M.L.V.N., L.D.H., R.P.D., G.N.H.); data interpretation (S.G., P.S.K., A.A.F., M.L.V.N., L.D.H., R.P.D., J.E.T., G.N.H.); preparation of initial draft of manuscript (P.S.K., A.A.F., M.L.V.N., G.N.H.); and review and approval of manuscript (all authors, as well as Study Officers of LSOCA, representing the SOCA Research Group, reviewed and approved the manuscript). The study was conducted with approval from the appropriate institutional review boards at each participating institution. Informed consent was obtained from all subjects, and the study was conducted in accordance with Health Insurance Portability and Accountability Act regulations. ",
year = "2012",
month = mar,
doi = "10.1016/j.ajo.2011.08.028",
language = "English (US)",
volume = "153",
pages = "434--444.e1",
journal = "American journal of ophthalmology",
issn = "0002-9394",
publisher = "Elsevier Inc.",
number = "3",
}
