获得性免疫缺陷综合征眼底病变特征分析

Ocular manifestations of acquired immunodeficiency syndrome

目的 观察获得性免疫缺陷综合征（AIDS）患者眼底病变特征.方法 经临床和实验室血清学检查确诊为AIDS并在眼科就诊发现有眼底病变的42例患者的66只眼纳入研究.所有患者均进行常规视力、裂隙灯显微镜、直接检眼镜检查及荧光素眼底血管造影（FFA）检查,对其眼底病变的临床特征进行回顾性分析.结果 66只眼中,巨细胞病毒性视网膜炎37只眼,占56.0%.眼底见视网膜上大片融合性黄白色颗粒状视网膜坏死灶,边界不清,伴视网膜出血,血管狭窄、阻塞和白鞘.人类免疫缺陷病毒微血管病变21只眼,占32.0%.眼底见视网膜棉绒斑、斑点状出血或微血管瘤.视神经病变3只眼,占4.5%.眼底见不同程度的视盘水肿、视神经炎或视神经萎缩.其他眼底病变5只眼,占7.5%.眼底表现为神经上皮脱离2只眼,占3.0%;葡萄膜炎3只眼,占4.5%.结论 进行性坏死性视网膜炎,视网膜出血,血管闭塞白鞘,棉绒斑是AIDS患者常见的眼底表现.

Objective To observe ocular manifestations of acquired immunodeficiency syndrome （AIDS）. Methods Fourty-two AIDS patients （66 eyes）with ocular complaints received examinations of visual acuity, slit-lamp microscope, ophthalmoscope and fundus fluorescence angiography （FFA）. The results were retrospectively analyzed. ResultsThere are five types of ocular findings, including cytomegalovirus （CMV） retinitis （37 eyes, 56.0%）, retinal microvasculopathy of human immunodeficiency virus （21 eyes, 32.0% ）, optic nerve diseases （three eyes, 4.5 % ）, retinal neuroepithelial layer detachment （two eyes, 3.0%） and uveitis （three eyes, 4.5%）. Conclusions The common ocular manifestations showed progressive necrotic retinitis, retinal hemorrhage and retinal vasculitis and attenuated, cotton-wool spots in AIDS patients.