In patients with AIDS-related cytomegalovirus retinitis (CMVR), subtle macular structure and microvasculature degeneration was found to occur among those without macular involved necrotic lesions, according to study results published in Frontiers in Medicine.
Patients with active and inactive AIDS-related CMVR plus healthy controls were recruited from a single center in Beijing between August and October 2019. The investigators compared all optical coherence tomography angiography parameters between groups after adjustment for signal strength.
Overall, 24 eyes from 17 patients with CMVR lesions and 32 eyes from 16 healthy controls were included. The signal strength in both the 3 × 3 mm and 6 × 6 mm scan patterns was significantly decreased among patients in the inactive CMVR group compared with the controls (both P <.001). Among only patients in the active CMVR group, the signal strength in the 3 × 3-mm scan was significantly decreased compared with the controls (P <.007).
After signal strength adjustment, no differences in foveal avascular zone areas were noted between the 3 groups. Of patients in the active and inactive CMVR groups, there was subtle macular microvasculature damage which displayed heterogeneity and a shift toward lower superficial and inner retinal vessel density. Among patients in the inactive CMVR group only, the choroidal vascularity index was significantly decreased in the central fovea, as well as in the superior, inferior, and nasal parafoveal quadrants (all P < .05).
Among patients in the inactive and active CMVR groups, both the retinal nerve fiber layer and inner nuclear layer had significantly increased thickness in all parafoveal quadrants compared with the controls (all P <.05). There were no significant differences in photoreceptor-retinal pigment epithelium thickness in the central fovea or parafoveal quadrants between the 3 groups.
The study was limited by its cross-sectional design, small sample size, absence of visual function parameters and their correlation to optical coherence tomography angiography findings, and potential bias of the retinal specialists who performed the scans.
According to the researchers, “using [swept-source optical coherence tomography angiography] with a 1050-nm wavelength, both macular structure and microvasculature can be monitored accurately and may aid in the prognosis of CMVR.”
Du KF, Huang XJ, Chen C, et al. Macular structure and microvasculature changes in AIDS-related cytomegalovirus retinitis using optical coherence tomography angiography. Front Med. Published online August 13, 2021. doi: 10.3389/fmed.2021.696447