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Comparison of intravitreal ganciclovir monotherapy and combination with foscarnet as initial therapy for cytomegalovirus retinitis 被引量:11
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作者 Jing-Jing Fan Yong Tao De-Kuang Hwang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2018年第10期1638-1642,共5页
AIM:To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newlyonset cytomegalovirus retinitis (CMVR).METHODS... AIM:To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newlyonset cytomegalovirus retinitis (CMVR).METHODS:The retrospective study observed 37 patients(58 eyes) who suffered from CMVR onset between 2013 and 2015. Among them, 35 eyes underwent 4 weekly intravitreal injections of 3.0 mg ganciclovir, and 23 eyes underwent 4 weekly injections of 3.0 mg ganciclovir combined with 2.4 mg foscarnet. Visual acuity, intraocular pressure and viral load of cytomegalovirus (CMV) in aqueous humor measured by real-time polymerase chain reaction were compared before and after each injection.RESULTS:CMV-DNA copies in aqueous humor decreased remarkably in both groups. The average of CMV-DNA copies in patients’ aqueous decreased from 38.3×10~4 copies/mL at baseline to 2.2×10~4 copies/mL after the 4^(th) injection in patients who were treated with ganciclovir monotherapy,and decreased from 76.9×10~4 copies/mL to 11.3×10~4 copies/mL after 4 continuous injections of ganciclovir combined with foscarnet. No significant difference was found in reduction of viral load, change of visual acuities or intraocular pressures between monotherapy or combined therapy.CONCLUSION:Results of this study show that the initial effectiveness of treating CMVR after 4 weekly intravitreal injections is not significantly different from ganciclovir alone or combined with foscarnet. Continuous injection of ganciclovir alone is sufficient in treating immunosuppressive patients with newly-onset CMVR. 展开更多
关键词 GANCICLOVIR foscarnet cytomegalovirus retinitis INTRAVITREAL visual acuity
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Comparative analysis of cytomegalovirus retinitis and microvascular retinopathy in patients with acquired immunodeficiency syndrome 被引量:10
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作者 Chao Chen Chun-Gang Guo +4 位作者 Li Meng Jing Yu Lian-Yong Xie Hong-Wei Dong Wen-Bin Wei 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2017年第9期1396-1401,共6页
AIM:To compare the clinical manifestation of cytomegalovirus(CMV)retinitis and microvascular retinopathy(MVR)in patients with acquired immunodeficiency syndrome(AIDS)in China.METHODS:A total of 93 consecutive ... AIM:To compare the clinical manifestation of cytomegalovirus(CMV)retinitis and microvascular retinopathy(MVR)in patients with acquired immunodeficiency syndrome(AIDS)in China.METHODS:A total of 93 consecutive patients with AIDS,including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed.Highly active antiretroviral therapy(HAART)status was recorded.HIV and CMV immunoassay were also tested.CD4+T-lymphocyte count and blood CMV-DNA test were performed in all patients.Aqueous humor CMV-DNA test was completed in 39patients.Ophthalmological examinations including best corrected visual acuity(BCVA,by International Standard Vision Chart),intraocular pressure(IOP),slit-lamp biomicroscopy,indirect ophthalmoscopy were performed.RESULTS:In MVR group,the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13.Blood CMV-DNA was 0(0,269 000)and 42 patients(80.77%)did not receive HAART.In CMV retinitis group,13 patients(31.71%)had anterior segment abnormality.The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470(0,1 450 000).Nineteen patients(46.34%)had not received HAART.MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%,respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION:In comparison of CMV,patients with MVR have relatively mild visual function impairment.Careful ophthalmological examination and close follow-up are mandatory,especially for patients who have systemic complications,positive CMV-DNA test and without received HAART. 展开更多
关键词 acquired immunodeficiency syndrome cytomegalovirus retinitis microvascular retinopathy CD4+ T-lymphocyte CMV-DNA highly active antiretroviral therapy
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Effect of individualized therapy for AIDS patients with cytomegalovirus retinitis in intravitreal ganciclovir injections 被引量:5
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作者 Lian-Yong Xie Chao Chen +4 位作者 Wen-Jun Kong Kui-Fang Du Chun-Gang Guo Hong-Wei Dong Wen-Bin Wei 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2019年第8期1351-1355,共5页
The effect of intravitreal ganciclovir injection combined with intravenous infusion on acquired immune deficiency syndrome(AIDS) patients with cytomegalovirus retinitis(CMVR) was investigated. A total of 32 eyes in 23... The effect of intravitreal ganciclovir injection combined with intravenous infusion on acquired immune deficiency syndrome(AIDS) patients with cytomegalovirus retinitis(CMVR) was investigated. A total of 32 eyes in 23 AIDS patients diagnosed as CMVR from 2017 to 2018 were included in the retrospective study. All patients underwent induction therapy by using intravenous drip of the anticytomegalovirus(CMV) agent ganciclovir(5 mg/kg q12 h) combined with intravitreal ganciclovir injection(3 mg/time, 2 times/wk). The visual acuity, fundus photographs, lesion location, and number of intravitreal injections were observed preoperatively and postoperatively. Totally 14 eyes were cured during induction therapy. The number of injections [4.13(2 to 6)] in CMVR patients with peripherally fundus lesions were significantly lower than those with central lesions (4.89(2 to 6))The individualized therapy of intravitreal ganciclovir injections for AIDS patients with CMVR can effectively reduce the numbers of intravitreal injections. 展开更多
关键词 cytomegalovirus retinitis acquired immune deficiency syndrome GANCICLOVIR INTRAVITREAL injection MONOTHERAPY
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Spectral-domain optical coherence tomography finding in cytomegalovirus retinitis in AIDS patients 被引量:2
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作者 Yan Sheng Yong-Zheng Guo +1 位作者 Li-Jun Xu Biao Zhu 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2020年第11期1800-1807,共8页
AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were en... AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were enrolled in the study.Complete ophthalmologic examinations,color fundus photography,SD-OCT and fundus autofluorescence(FAF)were performed for all patients at the first visit and each follow-up visit.Retinal necrosis in CMVR was analyzed on SD-OCT and classified into two types,the typical type and the atypical type.RESULTS:Forty-one eyes of active CMVR and 4 eyes of recurrent CMVR were classified into typical type,and 4 eyes with graying retinal lesion without hemorrhage or only punctate hemorrhage were classified into atypical type.In active stage of CMVR,the retina in typical type was significant thickened with hyperreflective lesion and full­thickness disruption of retinal architecture with enlarged vessel;while in atypical type,the retina was also destroyed in all layers but without thickening or slightly thinned.The choroid,vitreous and retinal vessels were not significantly involved.In healed stage,the retina was thin with destroyed layers in both types.In typical type,FAF showed mottled hypofluorescence mixed with punctuate hyperfluorescence.In atypical type,the retina showed some"cavity"in outer nuclear layer,and FAF showed mild hyperfluorescence.CONCLUSION:SD-OCT show different changes in the retina in typical type and atypical type of CMVR,which should be useful in assisting diagnosis and follow-up management of the disease. 展开更多
关键词 cytomegalovirus retinitis optical coherence tomography fundus autofluorescence
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Risk factors for the long-term prognosis and recurrence of HIV-negative cytomegalovirus retinitis in North China 被引量:1
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作者 Yan-Hong Shi Hui Wang +5 位作者 Hao Kang Jing Feng Xiao-Feng Hu Yun Li Zhu-Yun Qian Yong Tao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2022年第10期1634-1640,共7页
AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus(CMV) retinitis(CMVR) in HIV-negative patients.METHODS: HIV-negative patients with CMVR were invol... AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus(CMV) retinitis(CMVR) in HIV-negative patients.METHODS: HIV-negative patients with CMVR were involved in this study. Best corrected visual acuity(BCVA), intraocular pressure(IOP), CMV-DNA load in aqueous and/or serum samples, treatment, follow-up time, recurrence and complications were recorded. Ocular characteristics were evaluated by fundus photographs. Association between ocular factors and visual prognosis were analyzed by regression analysis.RESULTS: Twenty-five eyes of 16 patients were included. All 25 eyes underwent intravitreal injections of anti-viral agents. The mean log MAR BCVA improved from 0.94±0.98(0.98-0.78) initially to 0.77±0.73(0.82-0.68) at last visit, but not significantly. After antiviral treatment, the aqueous CMV DNA load significantly reduced to(3.42±1.47)×10~2 copies/m L(P=0.001), compared with(2.51±3.11)×10~5 copies/m L at baseline. Macular involvement(R~2=0.475, P=0.049) and initial visual acuity(R~2=0.475, P=0.017) were significantly associated with the poor visual prognosis(BCVA<20/400). The extent of retinal lesions(R~2=0.064, P=0.04) was significant associated with the risk of recurrence of CMVR.CONCLUSION: Intravitreal injection of anti-viral agents offers a safe and effective treatment for CMVR. Macular involvement and initial visual acuity significantly associate with visual prognosis. The extent of retinal lesions is significantly associated with the recurrence of CMVR. These ocular factors can be used as predictive risk factors for long term visual prognosis in HIV-negative CMVR patients. 展开更多
关键词 cytomegalovirus retinitis aqueous humor visual acuity risk factors RECURRENCE
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Successively bilateral cytomegalovirus retinitis in immunocompromised patient with Good's syndrome 被引量:1
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作者 Feng Hu Yuan Du Xiao-Yan Peng 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2018年第12期2021-2023,共3页
Dear Editor,I am Dr. Feng Hu, from the Department of Ophthalmology of Beijing Tongren Hospital, Beijing, China. I write to present a case report of cytomegalovirus retinitis (CMVR) in Good’s syndrome (GS).GS is an ex... Dear Editor,I am Dr. Feng Hu, from the Department of Ophthalmology of Beijing Tongren Hospital, Beijing, China. I write to present a case report of cytomegalovirus retinitis (CMVR) in Good’s syndrome (GS).GS is an extremely rare primary immune-deficiency syndrome,which consists of simultaneous occurrence of 展开更多
关键词 In Successively bilateral cytomegalovirus retinitis in immunocompromised patient with Good’s syndrome FIGURE
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Cytomegalovirus retinitis in the highly active anti-retroviral therapy era 被引量:1
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作者 Ifeoma N.Ude Steven Yeh Jessica G.Shantha 《Annals of Eye Science》 2022年第1期42-50,共9页
Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the p... Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment. 展开更多
关键词 cytomegalovirus(CMV) retinitis highly active antiretroviral therapy(HAART)
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Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome 被引量:3
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作者 GENG Shuang YE Jun-jie +2 位作者 ZHAO Jia-liang LI Tai-sheng HAN Yang 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第8期1134-1138,共5页
Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS)... Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4+ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 μg) were performed in 4 eyes (2 patients).Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4+ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×106/L (range,(0-85) × 106/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients. 展开更多
关键词 cytomegalovirus retinitis acquired immunodeficiency syndrome GANCICLOVIR
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CD4+ cells as a potential biomarker for cytomegalovirus retinitis in children with acute lymphocytic leukemia
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作者 Jian-Cang Wang Fei-Fan Du +3 位作者 Ming Su Xiao-Ge Yang Mei-Jie Quan Xiao-Ying Zhai 《Chinese Medical Journal》 SCIE CAS CSCD 2019年第3期356-359,共4页
To the Editor: Infection is one of the causes of death after chemotherapy in children with leukemia. About 20% to 30% acute lymphocytic leukemia (ALL) patients die from infection after chemotherapy.[1] Patients with i... To the Editor: Infection is one of the causes of death after chemotherapy in children with leukemia. About 20% to 30% acute lymphocytic leukemia (ALL) patients die from infection after chemotherapy.[1] Patients with immune deficiency, under chemotherapy, or treated with immunosuppressor are more inclined to be infected with human cytomegalovirus (HCMV) which leads to severe systematic disorders.[2] Cytomegalvirus retinitis (CMVR) is a major sight threatening disease which mainly occurs in patients with immune deficiency and results in blindness if treatment is delayed. The decrease of CD4+ T cells has been related to CMVR in immune deficiency syndrome like AIDS.[3] However, little is known about the relation between the level of T cells with different markers and the onset of CMVR in ALL patients under chemotherapy. Therefore, this study was designed to investigate the diagnostic value of T cells with different markers for cytomegalovirus retinitis after chemotherapy in patients with ALL. 展开更多
关键词 cytomegalovirus retinitis acute LYMPHOCYTIC LEUKEMIA CD4+ cells
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急性淋巴细胞白血病患儿化疗后合并巨细胞病毒性视网膜炎的临床特点及诊疗预后
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作者 任杰 徐莉 魏志杰 《当代医学》 2024年第14期126-129,共4页
目的分析急性淋巴细胞白血病(ALL)患儿化疗后合并巨细胞病毒(CMV)的临床特点及诊疗预后情况。方法回顾性分析2019年6月至2021年12月河北燕达陆道培医院收治的150例ALL化疗后患儿的临床资料,根据是否合并CMV感染分为感染组(n=50)与非感染... 目的分析急性淋巴细胞白血病(ALL)患儿化疗后合并巨细胞病毒(CMV)的临床特点及诊疗预后情况。方法回顾性分析2019年6月至2021年12月河北燕达陆道培医院收治的150例ALL化疗后患儿的临床资料,根据是否合并CMV感染分为感染组(n=50)与非感染组(n=100)。分析150例患儿CMV检测结果及临床特征,分析50例ALL合并巨细胞病毒视网膜炎(CMVR)患儿的临床资料及预后情况。结果150例ALL化疗后患儿中合并CMVR者50例,占比为33.33%。感染组年龄小于未感染组,最低血小板值、完全缓解率均低于未感染组,总化疗时长长于未感染组,中危占比高于未感染组,差异有统计学意义(P<0.05)。50例ALL合并CMVR患儿中,76.00%为双眼发病,50.00%为混合型病变,74.00%病变累及≥2个象限,30.00%病变累及黄斑,42.00%出现广泛视网膜血管炎;52.00%经抗CMV治疗后病情稳定。截止随访结束,ALL化疗后合并CMVR患儿共存活47例(94.00%)、死亡3例(6.00%)、复发3例(6.00%),其中早期骨髓复发1例(2.00%)、晚期骨髓复发2例(4.00%);总体生存率为(94.51±4.24)%、无事件生存率为(81.62±8.02)%。结论儿童ALL化疗后合并CMVR后及时进行全身抗病毒治疗,同时对其免疫功能进行检测,针对全身治疗不耐受且不良反应明显者可自玻璃体腔注射抗病毒药物,达到控制患者病情的目的。 展开更多
关键词 急性淋巴细胞白血病 巨细胞病毒性视网膜炎 临床特点 诊疗预后
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AIDS并发巨细胞病毒性视网膜炎 被引量:18
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作者 王焕玲 叶俊杰 +3 位作者 李太生 盛瑞媛 邱志峰 王爱霞 《中国艾滋病性病》 CAS 2003年第4期193-196,共4页
目的 探讨艾滋病 (AIDS)并发巨细胞病毒 (CMV)性视网膜炎的临床特点和治疗转归。方法 观察分析北京协和医院确诊为AIDS并发CMV视网膜炎的 5例患者的临床和实验室资料、治疗转归。结果  5例CMV视网膜炎患者的 9只眼均经眼底散瞳检查... 目的 探讨艾滋病 (AIDS)并发巨细胞病毒 (CMV)性视网膜炎的临床特点和治疗转归。方法 观察分析北京协和医院确诊为AIDS并发CMV视网膜炎的 5例患者的临床和实验室资料、治疗转归。结果  5例CMV视网膜炎患者的 9只眼均经眼底散瞳检查确诊。全部患者均为AIDS晚期患者 ,CD+ 4 T淋巴细胞计数 3~ 36 /mm3 ,在确诊CMV视网膜炎时均已合并其它机会性感染。平均年龄 2 9 2± 5 1岁。临床症状有视物模糊、视力下降等。眼底检查有典型的视网膜血管炎 ,表现为沿血管分布的黄白色病损、黄白色颗粒及视网膜出血 ,但玻璃体透明或轻微混浊。 4例接受更昔洛韦 (GCV)治疗的患者病情均得到控制 ,眼底病变消退 ,但其中 1例视力丧失 (失明 )无法恢复 ;1例患者未特殊治疗死于多种机会感染。结论 中国CMV视网膜炎的表现和国外文献报道的类似 ,多发生于晚期AIDS患者 ,不及时治疗将导致视力丧失 ,早期诊治非常重要。建议 :对于CD+ 4 T细胞计数 <5 0 /mm3 以及存在眼外CMV感染的AIDS患者 ,应常规作眼底检查 ;反之 ,对于拟诊CMV视网膜炎的所有患者 ,均应常规筛查血清HIV抗体。 展开更多
关键词 AIDS 巨细胞病毒性视网膜炎 并发症 艾滋病 治疗 转归
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膦甲酸钠与更昔洛韦比较治疗艾滋病相关巨细胞病毒视网膜炎疗效与安全性的系统评价 被引量:6
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作者 何清 孔双艳 +3 位作者 许诚 王松 赵连三 Phil Wiffen(英文审校) 《中国循证医学杂志》 CSCD 2006年第7期507-513,共7页
目的系统评价膦甲酸钠与更昔洛韦治疗艾滋病相关巨细胞病毒视网膜炎的疗效及安全性。方法电子检索PubMed(1966-2005.12)、EMbase(1974~2005.12)、 Cochrane图书馆(2005第4期)、中国生物医学文献数据库 (1978~2005.12)、中文生物医... 目的系统评价膦甲酸钠与更昔洛韦治疗艾滋病相关巨细胞病毒视网膜炎的疗效及安全性。方法电子检索PubMed(1966-2005.12)、EMbase(1974~2005.12)、 Cochrane图书馆(2005第4期)、中国生物医学文献数据库 (1978~2005.12)、中文生物医学期刊文献数据库(1994-2005.12)、中国学术期刊全文数据库(1994~2005.12)、中文科技期刊数据库 (1989~2005.12)。纳入比较膦甲酸钠和更昔洛韦治疗艾滋病相关巨细胞病毒视网膜炎的随机对照试验。由2名评价者对研究人群、干预措施与结果的详细资料独立地进行分析评价。对于同质数据进行Meta分析。结果共纳入5篇文献,其中3篇的研究对象虽来自同一研究人群,但采用了不同结局指标,故仍按3篇文献纳入,只是不合并相同指标在同一时间点的结果。Meta分析结果表明,膦甲酸钠在减少死亡人数[RR=0.84,95%CI( 0.70,1.00),P=0.05]和降低男性生殖器溃疡发生率[RR=1.29,95%CI(0.60,2.82), P=0.002]方面优于更昔洛韦;但在减轻眼部症状、延缓复发及其他副作用方面,两组间差异无统计学意义。结论本系统评价提示,膦甲酸钠在降低艾滋病合并巨细胞病毒视网膜炎患者死亡率及男性生殖器溃疡发生率方面比更昔洛韦可能更有效。但纳入研究数较少,证据强度有限,需更多高质量研究证实。 展开更多
关键词 膦甲酸钠 更昔洛韦 巨细胞病毒视网膜炎 疗效 安全性 系统评价
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玻璃体腔注射更昔洛韦治疗AIDS合并巨细胞病毒视网膜炎疗效观察 被引量:6
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作者 谢连永 陈超 +2 位作者 孔文君 郭纯刚 董宏伟 《疑难病杂志》 CAS 2019年第7期715-718,共4页
目的观察玻璃体腔注射更昔洛韦治疗AIDS合并巨细胞病毒性视网膜炎的效果。方法选取2015年7月-2018年11月首都医科大学附属北京佑安医院眼科确诊的AIDS合并巨细胞病毒性视网膜炎患者50例71眼,按随机数字表法分为3组,A组17例23眼,采用诱... 目的观察玻璃体腔注射更昔洛韦治疗AIDS合并巨细胞病毒性视网膜炎的效果。方法选取2015年7月-2018年11月首都医科大学附属北京佑安医院眼科确诊的AIDS合并巨细胞病毒性视网膜炎患者50例71眼,按随机数字表法分为3组,A组17例23眼,采用诱导期给予静脉滴注更昔洛韦5 mg·kg^-1·d^-1,q12 h,给药3周;B组16例21眼,采用诱导期患眼个性化玻璃体腔注射更昔洛韦3 mg/次,每周2次,共3周,C组17例27眼,采用在诱导期给予静脉滴注更昔洛韦5 mg·kg^-1·d^-1,1次/12 h,在此基础上给予患眼个性化玻璃体注射更昔洛韦3 mg/次,每周2次,如病情明显好转停止注射。3组患者诱导期结束后进入维持期口服更昔洛韦1 g/d。通过眼底照片、视力等对比来评估3组的治疗效果。结果治疗3周后C组总有效率100%高于A、B组的78.2%、85.7%(χ^2/P=6.522/0.0111、4.114/0.011)。3组患者治疗前视力处于相同水平,治疗后视力均高于治疗前,且C组>B组>A组(P均<0.01)。3组患者治疗前后眼压、CD4+T细胞、CD8+T细胞亚群比例、CD4+/CD8+均无明显变化(P>0.05)。结论玻璃体腔注射更昔洛韦治疗AIDS合并巨细胞病毒性视网膜炎疗效肯定,有应用价值。 展开更多
关键词 更昔洛韦 玻璃体腔注射 巨细胞病毒视网膜炎 艾滋病
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玻璃体内注射联合全身应用更昔洛韦治疗AIDS合并巨细胞病毒视网膜炎的临床疗效 被引量:6
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作者 卢淑文 蔡洁 +3 位作者 唐东永 谢子康 王芬 梁皓 《眼科新进展》 CAS 北大核心 2019年第9期840-844,共5页
目的观察玻璃体内注射联合全身应用更昔洛韦治疗AIDS合并巨细胞病毒视网膜炎(cytomegalovirus retinitis,CMVR)的临床疗效。方法收集2016年1月至2018年1月在广西医科大学第一附属医院收治的AIDS合并CMVR患者7例13眼。患者全身用药为更... 目的观察玻璃体内注射联合全身应用更昔洛韦治疗AIDS合并巨细胞病毒视网膜炎(cytomegalovirus retinitis,CMVR)的临床疗效。方法收集2016年1月至2018年1月在广西医科大学第一附属医院收治的AIDS合并CMVR患者7例13眼。患者全身用药为更昔洛韦和膦甲酸钠注射液,更昔洛韦 5.0~7.5 mg·kg^-1,每天2次静脉滴注;成人每次给予膦甲酸钠3 g,每天3次静脉滴注;同时在局部玻璃体内注射更昔洛韦。治疗前后对比的指标有:最佳矫正视力、眼压、眼底照相情况、视觉诱发电位、眼电图和视网膜电图等检查;检测指标包括CD4+T细胞计数,血液、前房水、玻璃体CMV-DNA病毒载量等。通过检查结果辅助判断治疗效果。结果 6例患者治疗后最佳矫正视力为(0. 72±0. 83) logM AR,较治疗前(1. 14±0. 83) logM AR提高(P=0. 001),其中1例患者经过全身和局部抗病毒治疗后视力不提高。患者治疗前后眼压均在正常范围内,治疗前为(13. 62±3. 04) mmH g(1 kP a=7. 5 mmH g),治疗后为(12. 77±2. 89) mmH g,差异无统计学意义(P=0. 119)。注药后患者眼底病变范围逐渐变小(P <0. 05)。治疗1个月后,患者视觉诱发电位N2-P2振幅及眼电图光峰电位较治疗前升高(均为P <0. 05),视觉诱发电位P2潜伏期和视网膜电图(明适应) a波及b波潜伏期和振幅治疗前后差异均无统计学意义(均为P>0. 05)。3例患者治疗前血液中CMV-DNA病毒载量检测为阴性,1例患者2眼经过治疗后眼内液中CMV-DNA病毒载量检测为阴性。治疗前玻璃体CMV-DNA病毒载量均明显高于前房水,而前房水CMV-DNA病毒载量又明显高于血液(均为P <0. 05),说明三个部位的CMV-DNA病毒载量从高到低的排列顺序为玻璃体>前房水>血液。治疗后玻璃体、前房水CMV-DNA病毒载量均低于治疗前,差异均有统计学意义(均为P <0. 05)。治疗前后血液CMV-DNA病毒载量差异无统计学意义(P> 0. 05)。治疗前后CD4+T细胞计数差异无统计学意义(P> 0. 05)。治疗前CD4+T细胞计数与眼内液、血液CMV-DNA病毒载量均呈负相关关系(均为P <0. 05);治疗过程中,CD4+T细胞计数与眼内液CMV-DNA病毒载量无相关关系(均为P> 0. 05),与血液CMV-DNA病毒载量呈负相关关系(P <0. 05),但两者之间不存在直线回归关系(P> 0. 05)。治疗前及治疗过程中玻璃体CMV-DNA病毒载量与前房水CMV-DNA病毒载量均存在正相关关系(回归方程分别为:Y=20 178. 973+0. 165X,Y=171 849. 77+0. 168X,均为P <0. 05)。所有患者术中和术后均未出现严重并发症。结论静脉滴注抗病毒药物联合玻璃体内注射小剂量更昔洛韦是治疗AIDS合并CMVR安全有效的治疗方法。 展开更多
关键词 获得性免疫缺陷综合征 巨细胞病毒视网膜炎 玻璃体内注射 更昔洛韦
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获得性免疫缺陷综合征并发巨细胞病毒视网膜炎患者抗病毒治疗前后视功能的变化 被引量:4
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作者 李上 谢连永 +4 位作者 于晶 凌宇 董宏伟 郭纯刚 潘志强 《眼科新进展》 CAS 北大核心 2014年第12期1170-1174,共5页
目的探讨获得性免疫缺陷综合征并发巨细胞病毒(cytomegalovirus,CMV)视网膜炎的患者在抗病毒治疗前后视功能的变化。方法对11例感染人类免疫缺陷病毒并且第1次发生CMV视网膜病变的患者,给予膦甲酸钠和更昔洛韦治疗。治疗前、治疗后1... 目的探讨获得性免疫缺陷综合征并发巨细胞病毒(cytomegalovirus,CMV)视网膜炎的患者在抗病毒治疗前后视功能的变化。方法对11例感染人类免疫缺陷病毒并且第1次发生CMV视网膜病变的患者,给予膦甲酸钠和更昔洛韦治疗。治疗前、治疗后1个月、3个月,通过多焦视网膜电图对每例患者的视功能进行评估,以未感染人类免疫缺陷病毒的正常人眼作为正常对照组,观察患眼视功能的改善情况。结果 CMV视网膜炎患者mf ERG一阶反应中心区域N1-P1的振幅密度,治疗前为(36.98±17.93)n V·deg^-2,治疗1个月后为(41.33±16.78)nV·deg^-2,治疗3个月后为(36.12±15.46)n V·deg^-2,正常对照组为(76.99±11.27)n V·deg^-2。患眼发病时与正常对照组相比较,1~4环区域mf ERG的一阶反应N1-P1的振幅密度均显著降低,差异有统计学意义(均为P〈0.05)。患眼在治疗后1个月和3个月,1~6环区域mf ERG的一阶反应N1波和P1波的潜时,以及N1-P1的振幅密度与治疗前相比均没有明显改变,差异均无统计学意义(均为P〉0.05)。结论 CMV视网膜炎的患者在经过积极地抗病毒治疗后,视力虽然能够得到不同程度上的恢复,但视网膜外层仍然受到不可逆的损伤,视网膜的功能显著降低。 展开更多
关键词 多焦电生理 巨细胞病毒视网膜炎 人类免疫缺陷病毒
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239例症状性巨细胞病毒感染的婴儿眼底分析 被引量:3
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作者 史彩平 葛莉莉 +4 位作者 陆斌 朱慧慧 任艳红 郑晓雨 冯佳 《大理大学学报》 CAS 2019年第10期1-6,共6页
目的:探讨婴儿巨细胞病毒感染后的眼底特征。方法:回顾性分析239例症状性巨细胞病毒感染婴儿的眼底情况。结果:65例有眼底异常:3例为全视网膜脉络膜炎,12例为眼底出血,49例为视网膜白色渗出灶,1例为眼底出血伴白色渗出灶。病变部位仅在... 目的:探讨婴儿巨细胞病毒感染后的眼底特征。方法:回顾性分析239例症状性巨细胞病毒感染婴儿的眼底情况。结果:65例有眼底异常:3例为全视网膜脉络膜炎,12例为眼底出血,49例为视网膜白色渗出灶,1例为眼底出血伴白色渗出灶。病变部位仅在Ⅰ区6例,Ⅱ区7例,Ⅲ区45例,同时在Ⅰ区、Ⅱ区2例,同时在Ⅱ区、Ⅲ区2例,有3例累及整个视网膜。经更昔洛韦足疗程治疗20例,18例病灶消失,2例留有色素紊乱及陈旧性病灶。未予治疗45例,残留眼底陈旧病灶4例。结论:对于症状性巨细胞病毒感染的婴儿,建议早期筛查眼底并定期复查,尤其是免疫低下或者免疫缺陷的患儿容易出现全视网膜脉络膜炎,建议尽早药物治疗。 展开更多
关键词 婴儿 巨细胞病毒 巨细胞病毒性视网膜炎
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获得性免疫缺陷综合征患者视网膜微血管病变与巨细胞病毒视网膜炎对比研究 被引量:6
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作者 谢连永 陈超 +4 位作者 孔文君 杜葵芳 董宏伟 郭纯刚 魏文斌 《眼科新进展》 CAS 北大核心 2019年第6期553-556,共4页
目的分析获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者视网膜微血管病变与巨细胞病毒视网膜炎(cytomegalovirus retinitis,CMVR)的疾病特征。方法回顾性病例分析。选取就诊于首都医科大学附属北京佑安医院眼科... 目的分析获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者视网膜微血管病变与巨细胞病毒视网膜炎(cytomegalovirus retinitis,CMVR)的疾病特征。方法回顾性病例分析。选取就诊于首都医科大学附属北京佑安医院眼科并经感染科专科医师确诊的AIDS患者145例,其中合并视网膜微血管病变者75例为微血管病变组,合并CMVR者70例为CMVR组。所有患者均进行AIDS相关病史询问,同时行血人类免疫缺陷病毒(HIV)载量和CD4+T细胞检测,并行最佳矫正视力、眼压、裂隙灯检查、散瞳眼底检查及彩色眼底照相等眼科检查。对全身情况允许的微血管病变组25例、CMVR组70例进行血液和房水CMV-DNA检测。结果视网膜微血管病变组最佳矫正视力为0.91±0.16,13例(17.33%)患者已开始高效联合抗反转录病毒治疗(HAART),CD4+T细胞数为22(0~506)个·μL^-1,8例(10.67%)患者有眼前节反应;CMVR组患者最佳矫正视力为0.63±0.37,34例(48.57%)患者已开始HAART,CD4+T细胞数为13(1~48)个·μL^-1,23例(32.85%)患者有眼前节反应,上述指标两组相比差异均有统计学意义(均为P=0.000)。微血管病变组25例中房水CMV-DNA阳性0例,血液CMV-DNA阳性8例(32.00%);CMVR组70例中房水CMV-DNA阳性60例(85.71%),血液CMV-DNA阳性33例(47.14%);两组血液中CMV-DNA阳性率相比差异无统计学意义(P=0.227),但房水中阳性率两组相比差异有统计学意义(P=0.000)。结论 AIDS合并CMVR患者比AIDS合并视网膜微血管病变患者视力更差,CD4+T细胞计数更低,眼前节反应及房水CMV-DNA阳性率更高,且视网膜微血管病变患者未接受HAART的人数明显高于CMVR患者。 展开更多
关键词 获得性免疫缺陷综合征 巨细胞病毒视网膜炎 视网膜微血管病变 CD4+T细胞
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巨细胞病毒性视网膜炎 被引量:13
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作者 李海燕 叶俊杰 《中国医学科学院学报》 CAS CSCD 北大核心 2003年第2期223-227,共5页
巨细胞病毒(cytomegalovirus,CMV)性视网膜炎是人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染/获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS,艾滋病)患者最常见的眼部机会性感染,是HIV相关性眼病引起视力... 巨细胞病毒(cytomegalovirus,CMV)性视网膜炎是人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染/获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS,艾滋病)患者最常见的眼部机会性感染,是HIV相关性眼病引起视力丧失的最主要原因,多发生于CD4+T淋巴细胞计数<50/mm3的患者。本文就CMV视网膜炎的发病情况、临床特点、并发症、鉴别诊断和治疗的研究进展进行综述。 展开更多
关键词 巨细胞病毒性视网膜炎 获得性免疫缺陷综合征 高效抗反转录酶病毒治疗
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巨细胞病毒性视网膜炎的治疗进展 被引量:5
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作者 何太雯 石英 《眼科新进展》 CAS 2008年第3期234-237,共4页
巨细胞病毒(cytomegalovirus,CMV)性视网膜炎是AIDS患者常见的机会感染,可引起视力下降或致盲,严重影响AIDS患者的生存质量。抗CMV的治疗可提高患者视力和生存质量。CMV性视网膜炎的治疗包括药物治疗、手术治疗、全身和局部联合治疗等,... 巨细胞病毒(cytomegalovirus,CMV)性视网膜炎是AIDS患者常见的机会感染,可引起视力下降或致盲,严重影响AIDS患者的生存质量。抗CMV的治疗可提高患者视力和生存质量。CMV性视网膜炎的治疗包括药物治疗、手术治疗、全身和局部联合治疗等,现将CMV性视网膜炎及其并发症的治疗做一综述。 展开更多
关键词 巨细胞病毒 视网膜炎 AIDS
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以眼部病变为首诊症状的获得性免疫缺陷综合征及人类免疫缺陷病毒感染 被引量:9
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作者 何太雯 卢洪洲 +4 位作者 杨娅玲 张仁芳 沈银忠 刘莉 江睿 《中国眼耳鼻喉科杂志》 2017年第1期23-27,共5页
目的探讨以眼部病变为首诊症状的获得性免疫缺陷综合征(AIDS)及人类免疫缺陷病毒(HIV)感染患者的眼部病变特点、临床症状。方法回顾系列病例研究。回顾分析29例(40眼)患者的临床资料,包括一般情况、视力、眼压、眼前节、眼底、眼底照相... 目的探讨以眼部病变为首诊症状的获得性免疫缺陷综合征(AIDS)及人类免疫缺陷病毒(HIV)感染患者的眼部病变特点、临床症状。方法回顾系列病例研究。回顾分析29例(40眼)患者的临床资料,包括一般情况、视力、眼压、眼前节、眼底、眼底照相及外周血CD4+T淋巴细胞检测、梅毒血清学检测、血清巨细胞病毒载量。结果 29例(40眼)患者中,HIV感染者8例,AIDS患者21例。患者初诊最佳矫正视力:无光感者2眼,光感~0.04者18眼,0.05~0.25者10眼,0.3~0.7者4眼,0.8及以上者6眼。15例(19眼)巨细胞病毒(CMV)性视网膜炎,11例(17眼)梅毒性葡萄膜炎,2例(3眼)CMV性视网膜炎合并梅毒性葡萄膜炎,1例(1眼)组织胞浆菌性视网膜炎。CMV性视网膜炎和梅毒性葡萄膜炎患者的CD4+T淋巴细胞计数分别为(27.80±25.44)、(259.45±177.38)个/μL,2组差异有统计学意义(P<0.05)。结论 CMV性视网膜炎和梅毒性葡萄膜炎是AIDS/HIV患者最常见的首诊眼病,抗CMV、驱梅治疗及抗反转录病毒治疗(HAART)可挽救患者视力。眼科医师应对CMV和梅毒性眼部病变予以警惕及重视。 展开更多
关键词 获得性免疫缺陷综合征 人类免疫缺陷病毒感染 巨细胞病毒性视网膜炎 梅毒性葡萄膜炎 组织胞浆菌性视网膜炎
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