Ausayakhun Somsanguan, Watananikorn Sopa, Ittipunkul Nimitr, Chaidaroon Winai, Patikulsila Prapatsorn, Patikulsila Direk
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
J Med Assoc Thai. 2003 May;86(5):399-406.
To identify the magnitude of ocular complications in HIV infection in Chiang Mai, and determine the signs or symptoms that indicate the risk factors for developing ocular complications in HIV-positive patients
A prospective study was carried out in newly diagnosed HIV-positive patients seen in the Ocular Infectious Disease Clinic of Maharaj Nakorn Chiang Mai Hospital from March 1, 2000 through February 28, 2001. A complete ophthalmic examination was performed on each patient together with a systemic evaluation of present illness and current medications.
Three-hundred and ninety-five HIV-positive patients were seen for ophthalmic evaluation. Of these, 90 were in stage A (asymptomatic), 84 were in stage B (symptomatic), and 221 were in stage C (AIDS). Ocular complications were found in 44.6 per cent of the patients. Cytomegalovirus (CMV) retinitis was the most common ophthalmic complication (33%). Other ocular complications included cotton wool spot (8%), uveitis (4%), optic neuropathy (3%), and keratoconjunctivitis sicca (2%). The clinical presenting symptoms, which were the indicators for ocular complications and CMV retinitis, included chronic cough, oral thrush, chronic diarrhea, weight loss, wasting, and skin disorders. Ocular symptoms, which indicated a high risk of developing CMV retinitis, included flashing, floaters, and scotoma.
Ocular complications are common in HIV-positive patients. CMV retinitis, which is a major vision-threatening problem, represented the most common finding. It is recommended that HIV-positive patients should have their eyes examined regularly, particularly when they have the clinical presenting symptoms previously mentioned. The patients should also notice early symptoms of CMV retinitis, which includes flashing, floaters, and scotoma.
确定清迈地区HIV感染患者眼部并发症的发生率，并确定HIV阳性患者发生眼部并发症的危险因素的体征或症状。
对2000年3月1日至2001年2月28日在清迈玛哈拉吉·那空医院眼科传染病诊所就诊的新诊断HIV阳性患者进行前瞻性研究。对每位患者进行了全面的眼科检查，并对现病史和当前用药情况进行了系统评估。
395例HIV阳性患者接受了眼科评估。其中，90例处于A期（无症状），84例处于B期（有症状），221例处于C期（艾滋病）。44.6%的患者发现有眼部并发症。巨细胞病毒（CMV）视网膜炎是最常见的眼科并发症（33%）。其他眼部并发症包括棉絮斑（8%）、葡萄膜炎（4%）、视神经病变（3%）和干燥性角结膜炎（2%）。作为眼部并发症和CMV视网膜炎指标的临床症状包括慢性咳嗽、口腔念珠菌病、慢性腹泻、体重减轻、消瘦和皮肤疾病。提示发生CMV视网膜炎高风险的眼部症状包括闪光感、飞蚊症和暗点。
眼部并发症在HIV阳性患者中很常见。CMV视网膜炎是一个主要的视力威胁问题，是最常见的发现。建议HIV阳性患者应定期进行眼部检查，尤其是当他们出现上述临床症状时。患者还应注意CMV视网膜炎的早期症状，包括闪光感、飞蚊症和暗点。
