As the population of PLWH ages, understanding the impact of cerebrovascular disease in this group becomes critical. However, there are few studies of cerebrovascular disease in HIV. The aim of this study was to compare the diameter of retinal vessels, a known biomarker of cardio- and cerebrovascular disease, between PLWH aged >50 years, PLWH aged <50 years and HIV-negative controls aged >50 years. The study included 120 men living with HIV aged >50 years, 39 younger men living with HIV and 52 HIV-negative men aged >50 years. Optic disc centred 45° colour fundus photographs were used to calculate central retinal arterial and venous calibre and the arterial-venous ratio (AVR). The study found no differences in retinal vascular indices between the three groups, suggesting that traditional risk factors but not HIV are associated with an increased burden of cerebral SVD.