Ocular Health Complications Among People Living with HIV/AIDS in Nigeria: Leveraging Doppler Ultrasonography to Identify and Manage Risk Factors

Abstract

Background and Objective: HIV-associated retinopathy and other ocular complications remain conditions of concern despite the introduction of combination antiretroviral therapy (ART). Evaluating people living with HIV (PLWH) for early hemodynamic changes in their ophthalmic arteries using Doppler ultrasonography is crucial to modifying care and preventing potential retinal damage. Methods: This case-control study included 150 eligible adults on ART and an equal number of age- and sexmatched apparently healthy HIV-negative controls. We performed a comprehensive ocular examination and determined Doppler velocimetric indices (resistive and pulsatility index) in both ophthalmic arteries using a 7.5 MHz transducer. Results: A total of 300 participants were included, of which 48% were males and 52% were females. The overall mean age (±standard deviation, SD) of participants was 41 ± 10 years. The prevalence of ocular abnormalities via fundoscopy was 13% among PLWH and 2% in the control group. The mean ophthalmic artery resistive indices (±SD) for HIV-positive participants were 0.73 (±0.05) in the right eye and 0.73 (±0.04) in the left eye, both higher than that of the apparently healthy controls at 0.68 (±0.05) and 0.67 (±0.05) in the right and left eyes, respectively. Similarly, the mean right and left ophthalmic artery pulsatility indices were higher among PLWH than controls (1.59 ± 0.35 and 1.60 ± 0.33 compared to 1.36 ± 0.33 and 1.44 ± 0.98, respectively). Conclusion and Implications for Translation: Ocular abnormalities are common among PLWH. Ophthalmic artery Doppler indices were significantly higher among PLWH than age- and sex-matched healthy controls, indicating some form of ocular vascular resistance. We recommend regular ocular examinations for PLWH in similar settings.