Illustration of a child's eye with healthy and affected foveas, representing the study's findings on HIV and retinal health.

Vision Beyond the Years: How HIV and CART Therapy are Changing Children's Eye Health

Nico Varela in Health & Wellness December 2025 • 5 min read.

"A groundbreaking study reveals unexpected links between HIV, CART therapy, and children's retinal health, offering new insights for parents and healthcare providers."

In the evolving landscape of pediatric healthcare, advancements in treatments for conditions like HIV are constantly reshaping our understanding of long-term health implications. One such area of growing interest is the impact of HIV and its treatments, specifically combination antiretroviral therapy (CART), on children's eye health. A recent study has brought to light some surprising and important findings that have implications for the vision of children undergoing these treatments.

The study delves into the subtle yet significant changes in the retina, the light-sensitive tissue at the back of the eye. It compares children with perinatally acquired HIV, who are undergoing CART treatment, with a group of healthy, age-matched controls. The goal is to identify any structural or functional differences in the retina and to understand how they relate to the disease itself and its treatment.

This article unpacks the key findings of this research, discussing the unexpected connections found between HIV, CART therapy, and the retinal health of children. It aims to inform parents, healthcare providers, and anyone interested in the long-term effects of these treatments, providing a clear picture of the current understanding and what future research directions might hold.

Unveiling the Retina: What the Study Found

Illustration of a child's eye with healthy and affected foveas, representing the study's findings on HIV and retinal health.

The research, conducted by a team of specialists in ophthalmology and infectious diseases, employed advanced techniques to meticulously examine the retinas of the participants. Using spectral-domain optical coherence tomography (SD-OCT), they measured the thickness of various retinal layers, providing a detailed view of the eye's internal structure. This advanced imaging technique allows for a comprehensive and non-invasive assessment of the retina's health.

The results of the study revealed some striking differences between the two groups. The HIV-infected children showed a significantly thinner total foveal thickness compared to the healthy controls. The fovea is a crucial part of the retina, responsible for sharp central vision. Furthermore, the study found a connection between the thickness of the fovea and the peak viral load of HIV. This means that children with higher viral loads tended to have thinner foveas, pointing to a potential link between the virus and retinal health.

Thinner Fovea: HIV-infected children showed a reduction in the thickness of their fovea, a key area for sharp vision.
Viral Load Connection: Higher levels of the virus in the blood were associated with thinner foveas, suggesting a direct impact.
No RNFL Difference: Surprisingly, there was no significant difference in the thickness of the retinal nerve fiber layer (RNFL) between the two groups, which is often affected in adults.

These findings open up new avenues of inquiry. The researchers note that while the study observed a decrease in foveal thickness, they did not find significant differences in other areas, like the RNFL. This highlights that the impact of HIV and its treatment might manifest differently in children than in adults, who often exhibit RNFL thinning. The study emphasizes the need for further longitudinal studies. They are crucial for confirming these initial findings and for understanding the course and the clinical consequences of these changes in children's vision over time.

Looking Ahead: The Future of Vision and HIV Treatment in Children

The study's results are a significant step forward in understanding the impact of HIV and its treatments on children's vision. They highlight the need for ongoing research and monitoring to ensure that children with HIV receive the best possible care. With further studies, the healthcare community can gain deeper insights into the long-term effects of HIV and CART therapy. This will help to develop targeted strategies for protecting and preserving the vision of these children. It is a testament to the ongoing commitment to improving the health outcomes and quality of life for those affected by HIV.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1167/iovs.15-16855, Alternate LINK

Title: Retinal Structure And Function In Perinatally Hiv-Infected And Cart-Treated Children: A Matched Case–Control Study

Subject: General Medicine

Journal: Investigative Opthalmology & Visual Science

Publisher: Association for Research in Vision and Ophthalmology (ARVO)

Authors: Nazli Demirkaya, Sophie Cohen, Ferdinand W. N. M. Wit, Michael D. Abramoff, Reinier O. Schlingemann, Taco W. Kuijpers, Peter Reiss, Dasja Pajkrt, Frank D. Verbraak

Published: 2015-06-16

Everything You Need To Know

What specific changes in retinal health were observed in children with HIV undergoing CART therapy?

The study found that HIV-infected children undergoing CART therapy showed a significantly thinner total foveal thickness compared to healthy controls. The fovea is the central part of the retina responsible for sharp, central vision. However, the study did not find significant differences in the thickness of the retinal nerve fiber layer (RNFL) between the two groups, which is often affected in adults with HIV. These changes suggest that HIV and its treatment may impact children's retinal structure differently than adults.

How does viral load impact retinal health in children with HIV, according to the study?

The research indicated a direct connection between the peak viral load of HIV and the thickness of the fovea. Children with higher viral loads tended to have thinner foveas. This suggests that the virus itself may directly impact retinal health, specifically affecting the development or maintenance of the fovea, which is critical for detailed vision. This finding emphasizes the importance of managing viral load through effective CART therapy to potentially mitigate retinal changes.

What is spectral-domain optical coherence tomography (SD-OCT), and why was it used in this study?

Spectral-domain optical coherence tomography (SD-OCT) is an advanced imaging technique that allows for a detailed and non-invasive assessment of the retina's structure. It was used in the study to measure the thickness of various retinal layers, including the fovea and the retinal nerve fiber layer (RNFL). SD-OCT provides high-resolution cross-sectional images of the retina, enabling researchers to identify subtle structural differences between HIV-infected children and healthy controls. This precise measurement is essential for detecting early signs of retinal changes that might not be visible through traditional eye exams.

The study highlights the need for longitudinal studies. Why are these types of studies important in understanding the long-term effects of HIV and CART therapy on children's vision?

Longitudinal studies are crucial for understanding the long-term effects of HIV and CART therapy on children's vision because they follow the same individuals over an extended period. This allows researchers to observe how retinal changes evolve over time and whether these changes correlate with visual function or other health outcomes. By tracking children's retinal health from early stages of HIV infection and CART treatment, researchers can identify potential risk factors, predict the progression of retinal changes, and assess the effectiveness of interventions aimed at preserving vision. These studies can also reveal whether the initial changes observed in the fovea lead to clinically significant vision problems later in life.

How might the findings of this study influence future strategies for protecting and preserving the vision of children with HIV?

The findings emphasize the need for regular eye exams, including advanced imaging techniques like SD-OCT, for children with HIV, especially those undergoing CART therapy. The link between viral load and foveal thickness suggests that maintaining low viral loads through effective CART therapy is crucial for protecting retinal health. Future research could focus on developing targeted interventions to promote foveal development or prevent further thinning in children with high viral loads or those who exhibit early signs of retinal changes. Understanding the specific mechanisms by which HIV and CART therapy impact the retina could also lead to the development of novel therapies to preserve vision and improve the quality of life for children affected by HIV.