Surreal illustration of an eye connected to neural pathways.

Window to the Brain: How HIV Affects the Eyes and Brain in Children

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"New research reveals the link between retinal health and white matter integrity in HIV-infected children, offering insights into early brain damage."

While combination antiretroviral therapy (CART) has significantly improved the lives of children with perinatal HIV, neurological and cognitive challenges persist. These can manifest as decreased brain volume and microstructural white matter injury. Considering the close connection between the brain and neuroretinal tissue, researchers have been exploring if these deficits share common origins.

A recent study delved into this connection, assessing the relationship between neuroretinal thickness and cerebral injury in HIV-infected children undergoing CART treatment, comparing them with a control group of healthy children. The goal was to understand if changes in the retina could reflect changes in the brain.

By examining the associations between retinal measurements and brain imaging data, this research aimed to shed light on the pathogenesis of HIV-induced cerebral injury in children, and whether the eye could indeed serve as a "window to the brain".

The Eye-Brain Connection: What the Study Revealed

Surreal illustration of an eye connected to neural pathways.

The study involved 29 HIV-infected children on CART and 35 healthy controls. Each participant underwent a comprehensive evaluation, including magnetic resonance imaging (MRI) to assess brain volume and white matter integrity, and spectral-domain optical coherence tomography (SD-OCT) to measure the thickness of different layers in the retina.

Researchers then analyzed the data to identify any correlations between retinal thickness and brain parameters, taking into account factors such as age, sex, and socioeconomic status. The key findings highlighted a significant connection:

In HIV-infected children, decreased foveal and pericentral neuroretinal thickness was associated with damaged white matter microstructure (lower fractional anisotropy, higher mean and radial diffusivity).
In healthy controls, neuroretinal thickness was linked to gray and white matter volume.
This suggests that HIV-induced retinal thinning and white matter injury may share a common pathogenesis.

These findings suggest that HIV's impact extends beyond brain volume reduction. It affects the intricate structure of the white matter, disrupting communication pathways. The eye, specifically the retina, reflects these changes. It acts as a readily accessible indicator of deeper neurological issues. Monitoring retinal thickness could offer a non-invasive way to track disease progression and treatment effectiveness.

Why This Matters: Implications for the Future

This research marks a significant step in understanding the long-term neurological effects of HIV in children, even with effective viral suppression. By identifying a link between retinal health and white matter integrity, it opens new avenues for early detection and intervention.

Further research is needed to fully elucidate the mechanisms driving these changes and to determine if monitoring retinal thickness can predict long-term neurological outcomes. Longitudinal studies, tracking changes in both the eye and brain over time, will be crucial.

Ultimately, this knowledge could lead to more targeted therapies and interventions to protect the developing brains of children with HIV, ensuring they reach their full cognitive potential.

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.16-19716, Alternate LINK

Title: The Eye As A Window To The Brain: Neuroretinal Thickness Is Associated With Microstructural White Matter Injury In Hiv-Infected Children

Subject: General Medicine

Journal: Investigative Opthalmology & Visual Science

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

Authors: Charlotte Blokhuis, Nazli Demirkaya, Sophie Cohen, Ferdinand W. N. M. Wit, Henriëtte J. Scherpbier, Peter Reiss, Michael D. Abramoff, Matthan W. A. Caan, Charles B. L. M. Majoie, Frank D. Verbraak, Dasja Pajkrt

Published: 2016-07-22

Everything You Need To Know

What did the study discover about the connection between retinal thickness and white matter in HIV-infected children?

The study revealed that in HIV-infected children, a decrease in the foveal and pericentral neuroretinal thickness was associated with damaged white matter microstructure. This means that the thinning of the retina, as measured by spectral-domain optical coherence tomography (SD-OCT), correlated with issues in the brain's white matter, specifically lower fractional anisotropy and higher mean and radial diffusivity, indicating damage to the white matter's structure. This suggests a common pathway of injury.

Why is combination antiretroviral therapy (CART) not always enough in treating HIV in children?

Combination antiretroviral therapy (CART) has improved the lives of children with perinatal HIV. Although CART has been effective in managing HIV, it does not fully resolve neurological and cognitive challenges. Decreased brain volume and microstructural white matter injury can still occur. These issues highlight the continued need for monitoring and intervention strategies, even when viral load is suppressed.

What methods were used to assess the eye and brain in this study?

The study utilized magnetic resonance imaging (MRI) and spectral-domain optical coherence tomography (SD-OCT). MRI was used to assess the brain volume and white matter integrity, providing detailed images of the brain's structure. SD-OCT was used to measure the thickness of different layers in the retina. These methods enabled researchers to establish correlations between retinal measurements and brain parameters, thereby exploring the eye-brain connection.

Why is this research important for the future of treating HIV in children?

The significance of this research lies in its potential for early detection and intervention. The research found that changes in the retina, such as thinning, could serve as an indicator of white matter injury in the brain. By monitoring retinal health using methods like SD-OCT, doctors might be able to detect neurological problems early on. This early detection could allow for earlier and more effective interventions, potentially mitigating some of the long-term effects of HIV on the brain.

What was the main focus of this research, and what does it suggest?

The study focused on the link between retinal thickness and white matter integrity, specifically in HIV-infected children undergoing combination antiretroviral therapy (CART). The research revealed that changes in retinal thickness, as measured by SD-OCT, correlated with changes in the brain's white matter. This connection suggests that the eye, particularly the retina, can act as a 'window to the brain,' offering insights into early brain damage caused by HIV. It also opens up the possibility of monitoring the disease's progression and treatment effectiveness through non-invasive retinal exams.