获得性免疫缺陷综合征合并巨细胞病毒性视网膜炎患眼光相干断层扫描图像特征

The image characteristics of optical coherence tomography in patients of acquired immunodeficiency syndrome with cytomegalovirus retinitis

目的观察获得性免疫缺陷综合征(AIDS)合并巨细胞病毒视网膜炎(CMVR)患眼OCT图像特征。方法2015年1月至2017年12月在首都医科大学附属北京地坛医院眼科检查确诊的AIDS合并后极部CMVR患者26例39只眼纳入研究。患者均为男性,平均年龄(33.12±9.87)岁。采用德国Heidelberg公司Spectralis HRA+OCT设备行频域OCT检査。扫描区域包括视盘、黄斑区以及病变区域及邻近视网膜。典型图像存盘分析。结果所有患眼病变中心区视网膜增厚,反射增强;病变累及区域以及病变外周区域椭圆体带(EZ)缺失或结构改变。39只眼中,病变周边视网膜外层点状强反射6只眼(15.38%),视网膜全层点状强反射31只眼(79.49%);病变累及黄斑区25只眼(64.10%);可见玻璃体细胞34只眼(87.17%)。结论AIDS合并CMVR患眼OCT图像特征为病变累及视网膜全层;病变累及区域以及病变外周区域可见EZ缺失或结构改变。

Objective To observe the image characteristics of OCT in patients of acquired immunodeficiency syndrome(AIDS)with cytomegalovirus retinitis(CMVR).Methods Thirty-nine eyes of 26 patients of AIDS with CMVR diagnosed in Department of ophthalmology of Beijing Ditan Hospital Capital Medical University from January 2015 to December 2017 were included in this study.All the patients were males,with the mean age of 33.12±9.87 years.All the patients underwent the OCT examination by Spectralis HRA+OCT.The locations of scanning were macular,optical papilla and posterior pole of retina with retinitis.Typical images were saved and analyzed.Results The OCT pathological changes of CMVR included increase of retinal thickness and reflex of retina,indiscernible retinal layers,irregularity or absent external limiting membrane and/or ellipsoid zone,hyperreflective spots,vitreous cells.Among 39 eyes,there were 6 eyes with strong point-like reflection in the outer layer of retina around the lesion,31 eyes(79.49%)with strong point-like reflection in the full layer of retina,25 eyes(64.10%)with lesion involved macular area,34 eyes(87.17%)with vitreous cells.Conclusions OCT images of the eyes with AIDS with CMVR were characterized by lesions involving the whole retina.Absent ellipsoid zone or structural changes can be seen in the affected areas and peripheral areas of the lesion.