Cytomegalovirus retinitis associated with Acquired immunodeficiency syndrome
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OPHTHALMOLOGY
- Issue:
- 9
- DOI:
- 10.3760/j:issn:0412-4081.2005.09.008
- Key Word:
- 巨细胞病毒视网膜炎;获得性免疫缺陷综合征;视神经萎缩
Abstract： 目的探讨获得性免疫缺陷综合征(acquired immunodeficiency syndrome, AIDS)并发巨细胞病毒(cytomegalovirus, CMV)性视网膜炎的眼底表现特点、全身症状及治疗预后.方法观察8例(15只眼)AIDS并发CMV性视网膜炎的临床表现,分析其眼底、视力、荧光素眼底血管造影及CD4+T淋巴细胞检测结果,并对其中2例(4只眼)行更昔洛韦玻璃体腔注药治疗.随访时间2～34个月,平均16个月.结果初诊视力≤0.2者10只眼(66.7%),其中无光感者2只眼,眼前光感者2只眼,0.04～0.20者6只眼;0.8和0.9者各1只眼(13.3%);≥1.0者3只眼(20.0%).12只眼的眼底表现为视网膜血管炎特点,呈沿血管分布的浓厚黄白色病损,其上有片状出血,边缘为不规则的黄白色颗粒,可形象描述为"奶酪加番茄酱样视网膜炎";玻璃体透明或反应轻微.2只眼的眼底呈晚期表现,视网膜萎缩呈灰色,视网膜血管硬化、狭窄,视网膜色素上皮萎缩,可透见脉络膜血管及视神经萎缩.1只眼视网膜脱离.8例患者的CD4+T淋巴细胞计数在0～36个/mm3之间,平均(15.0±12.9)个/mm3.4只眼玻璃体注药后视力均显著提高.眼底病变明显消退,出血吸收.结论 CMV性视网膜炎是AIDS最常见、最严重的眼部并发症.眼底表现特点为进行性、坏死性视网膜炎伴出血,同时合并有视网膜血管炎.但玻璃体反应无或轻微.对原因不明的黄白色病损、视网膜出血及视网膜血管炎应行血清人类免疫缺陷病毒(human immunodeficiency virus, HIV)抗体检测.反之,HIV阳性者应常规进行眼底检查.
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