Association of Systemic Inflammation With Retinal Vascular Caliber in Patients With AIDS

PURPOSE. To evaluate relationships among retinal vascular caliber and biomarkers of systemic inflammation in patients with AIDS. METHODS. A total of 454 participants with AIDS had retinal vascular caliber (central retinal artery equivalent and central retinal vein equivalent) determined from enrollment retinal photographs by reading center graders masked to clinical and biomarker information. Cryopreserved plasma specimens were assayed for inflammatory biomarkers, including C-reactive protein (CRP), IL-6, interferon-gamma inducible protein (IP)-10, kynurenine/tryptophan (KT) ratio, and intestinal fatty acid binding protein (I-FABP). RESULTS. In the simple linear regression of retinal vascular caliber on plasma biomarkers, elevated CRP, IL-6, and IP-10 were associated with retinal venular dilation, and elevated KT ratio with retinal arteriolar narrowing. In the multiple linear regression, including baseline characteristics and plasma biomarkers, AMD was associated with dilation of retinal arterioles (mean difference: 9.1 mu m; 95% confidence interval [CI] 5.2, 12.9; P < 0.001) and venules (mean difference, 10.9 mu m; 95% CI, 5.3, 16.6; P < 0.001), as was black race (P < 0.001). Hyperlipidemia was associated with retinal venular narrowing (mean difference, -7.5 mu m; 95% CI, -13.7, -1.2; P = 0.02); cardiovascular disease with arteriolar narrowing (mean difference, -5.2 mu m; 95% CI, -10.3, -0.1; P = 0.05); age with arteriolar narrowing (slope, -0.26 mu m/year; 95% CI, -0.46, -0.06; P = 0.009); and IL-6 with venular dilation (slope, 5.3 mu m/standard deviation log(10)[plasma IL-6 concentration]; 95% CI, 2.7, 8.0; P < 0.001). CONCLUSIONS. These data suggest that retinal vascular caliber is associated with age, race, AMD, hyperlipidemia, cardiovascular disease, and selected biomarkers of systemic inflammation.