Rauz S, Murray P I
Academic Unit of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust.
Sex Transm Infect. 1999 Feb;75(1):18-20. doi: 10.1136/sti.75.1.18.
Cytomegalovirus (CMV) retinitis is the commonest ocular complication of AIDS and the prevention of recurrence has been dependent on lifelong maintenance treatment. Recently there has been a dramatic downturn in the number of new cases of CMV retinitis, which has been attributed to the introduction of highly active antiretroviral therapy (HAART) and subsequent improved survival. Whereas paucity of inflammation has been considered to be the hallmark of the ophthalmic manifestations of AIDS, with immune recovery, a new pattern of ophthalmic AIDS has emerged. This is characterised by a heightened inflammatory response and more frequent complications associated with this response--for example, vitritis, cystoid macular oedema. In spite of this, regression of CMV retinitis has been reported, as well as absence of reactivation or progression after withdrawal of anti-CMV maintenance treatment. How long this situation will continue is not known and we remain cautious about the future of CMV retinitis and other opportunistic ocular infections.
巨细胞病毒（CMV）视网膜炎是艾滋病最常见的眼部并发症，预防复发一直依赖于终身维持治疗。最近，CMV视网膜炎新病例数量急剧下降，这归因于高效抗逆转录病毒疗法（HAART）的引入及随后生存率的提高。虽然炎症反应不明显一直被认为是艾滋病眼部表现的特征，但随着免疫功能的恢复，一种新的艾滋病眼部病变模式出现了。其特点是炎症反应增强以及与此反应相关的并发症更频繁，例如玻璃体炎、黄斑囊样水肿。尽管如此，仍有报告称CMV视网膜炎有所消退，并且在停用抗CMV维持治疗后没有再激活或进展。这种情况会持续多久尚不清楚，我们对CMV视网膜炎和其他机会性眼部感染的未来仍持谨慎态度。
