Retinal vascular occlusion in patients infected with human immunodeficiency virus

James P. Dunn, Andrea Yamashita, John H. Kempen, Douglas Jabs

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the clinical features of retinal vascular occlusions (macrovasculopathy) and the proportion of affected patients with human immunodeficiency virus (HIV) infection. Methods: Retrospective chart review of all HIV-infected individuals with retinal vascular occlusions seen at a single tertiary care clinic between November 1983 and May 1998. Results: Retinal vascular occlusion was found in 38 eyes of 33 (1.3%) of the 2,484 consecutive patients examined. Of the 33 patients, 16 (48.5%) had central retinal vein occlusion, 9 (27.3%) had branch retinal vein occlusion, 4 (12.1%) had hemiretinal vein occlusion, and 1 each (3.0%) had central retinal arterial occlusion, branch retinal arterial occlusion, and combined hemiretinal vein occlusion and branch retinal artery occlusion. One patient (3.0%) had Purtscher-like retinopathy in one eye. Multiple regression analysis revealed that macrovasculopathy was associated with the presence of noninfectious retinal microvasculopathy (odds ratio, 5.76; 95% confidence interval, 2.59-12.80). Vision at the time of diagnosis ranged between 20/20 and no light perception. Twenty-five (75.8%) of the 33 patients had follow-up examinations for a mean period of 9.1 months. Ocular findings during follow-up included capillary dropout in 3 patients (11.5%), posterior pole neovascularization in 4 (15.4%), vitreous hemorrhage in 4 (15.4%), and optic atrophy in 6 (23.1%). Vision at the last eye examination ranged between 20/20 and no light perception and was 20/200 or worse in 15 (39.5%) of 38 eyes. Conclusions: Patients with HIV infection have a small risk of retinal vascular occlusion, but complications and visual loss are common in affected patients. There is a strong association between noninfectious retinal microvasculopathy and retinal vein occlusions.

Original languageEnglish (US)
Pages (from-to)759-766
Number of pages8
JournalRetina
Volume25
Issue number6
DOIs
StatePublished - Sep 2005

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Retinal Vessels
HIV
Retinal Vein Occlusion
Virus Diseases
Veins
Retinal Artery Occlusion
Retinal Vein
Vitreous Hemorrhage
Light
Tertiary Healthcare
Odds Ratio
Regression Analysis
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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Retinal vascular occlusion in patients infected with human immunodeficiency virus. / Dunn, James P.; Yamashita, Andrea; Kempen, John H.; Jabs, Douglas.

In: Retina, Vol. 25, No. 6, 09.2005, p. 759-766.

Research output: Contribution to journalArticle

Dunn, James P. ; Yamashita, Andrea ; Kempen, John H. ; Jabs, Douglas. / Retinal vascular occlusion in patients infected with human immunodeficiency virus. In: Retina. 2005 ; Vol. 25, No. 6. pp. 759-766.
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abstract = "Purpose: To describe the clinical features of retinal vascular occlusions (macrovasculopathy) and the proportion of affected patients with human immunodeficiency virus (HIV) infection. Methods: Retrospective chart review of all HIV-infected individuals with retinal vascular occlusions seen at a single tertiary care clinic between November 1983 and May 1998. Results: Retinal vascular occlusion was found in 38 eyes of 33 (1.3{\%}) of the 2,484 consecutive patients examined. Of the 33 patients, 16 (48.5{\%}) had central retinal vein occlusion, 9 (27.3{\%}) had branch retinal vein occlusion, 4 (12.1{\%}) had hemiretinal vein occlusion, and 1 each (3.0{\%}) had central retinal arterial occlusion, branch retinal arterial occlusion, and combined hemiretinal vein occlusion and branch retinal artery occlusion. One patient (3.0{\%}) had Purtscher-like retinopathy in one eye. Multiple regression analysis revealed that macrovasculopathy was associated with the presence of noninfectious retinal microvasculopathy (odds ratio, 5.76; 95{\%} confidence interval, 2.59-12.80). Vision at the time of diagnosis ranged between 20/20 and no light perception. Twenty-five (75.8{\%}) of the 33 patients had follow-up examinations for a mean period of 9.1 months. Ocular findings during follow-up included capillary dropout in 3 patients (11.5{\%}), posterior pole neovascularization in 4 (15.4{\%}), vitreous hemorrhage in 4 (15.4{\%}), and optic atrophy in 6 (23.1{\%}). Vision at the last eye examination ranged between 20/20 and no light perception and was 20/200 or worse in 15 (39.5{\%}) of 38 eyes. Conclusions: Patients with HIV infection have a small risk of retinal vascular occlusion, but complications and visual loss are common in affected patients. There is a strong association between noninfectious retinal microvasculopathy and retinal vein occlusions.",
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