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目的了解未经抗巨细胞病毒治疗时获得性免疫缺陷综合征(艾滋病)合并巨细胞病毒性视网膜炎的临床特征及其预后。设计回顾性病例系列。研究对象11例未经抗巨细胞病毒治疗的艾滋病合并巨细胞病毒性视网膜炎患者。方法所有患者查矫正视力、非接触眼压、裂隙灯显微镜检查、动态视野、散瞳间接检眼镜检查、眼底照相,并行CD4 T淋巴细胞检测。随访2个月~5年(平均26.2±23.8个月),观察病程过程中各项指标的变化。主要指标矫正视力、眼前后节情况。结果 11例(21眼)发病,其中14眼无光感,矫正视力<0.05者2例(2眼),0.05≤矫正视力<0.3者1例(1眼),矫正视力≥0.3者3例(4眼);21眼中,5眼仅有不同程度的角膜后色素性KP,余16眼除角膜KP外,均有不同程度的白内障;21眼中13眼有不同程度虹膜前后粘连,2例(3眼)合并角膜白斑、角膜血管翳,影响外观。眼底能窥入者9眼,表现为不同程度眼底瘢痕性改变,合并视网膜脱离者2眼。结论未经抗巨细胞病毒治疗的艾滋病合并巨细胞病毒性视网膜炎患者视力预后差,除眼底病变外,还可引起眼前节病变。
Objective To investigate the clinical characteristics and prognosis of acquired immunodeficiency syndrome (AIDS) combined with cytomegalovirus retinitis without anti-cytomegalovirus treatment. Design retrospective case series. Eleven patients without AIDS treated with anti-cytomegalovirus were treated with cytomegalovirus retinitis. Methods All patients were examined for corrected visual acuity, non-contact intraocular pressure, slit lamp microscopy, dynamic field of vision, mydriatic indirect ophthalmoscopy, fundus photography, parallel CD4 T lymphocyte assay. The follow-up ranged from 2 months to 5 years (mean 26.2 ± 23.8 months). The changes of various indexes during the course of disease were observed. Main indicators of vision correction, eye condition before and after. Results In 11 cases (21 eyes), 14 cases had no light perception, corrected visual acuity <0.05 in 2 cases (2 eyes), 0.05≤ corrected visual acuity <0.3 in 1 case (1 eye), corrected visual acuity ≥ 0.3 in 3 cases 4 eyes); in 21 eyes, only 5 eyes had different degrees of post-corneal pigmentation KP, more than 16 eyes had different degrees of cataract except corneal KP; 13 eyes had different degree of anterior and posterior ipsilateral adhesions in 21 eyes, 2 cases (3 Eye) combined corneal leukoplakia, corneal angiosperm, affecting the appearance. Fundus 9 patients can peep into the eyes, showing varying degrees of scarring of the fundus, retinal detachment in 2 eyes. Conclusion The AIDS patients with cytomegalovirus retinopathy who have not been treated with anti-cytomegalovirus have poor visual acuity. In addition to fundus lesions, they may also cause anterior segment lesions.