Chuang E L, Davis J L
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, FL 33136.
Eye (Lond). 1992;6 ( Pt 1):28-34. doi: 10.1038/eye.1992.4.
In patients with AIDS, the most important ocular opportunistic infection, CMV retinitis, can now be treated effectively with virostatic agents. Associated retinal detachment is encountered frequently, and its management has become increasingly significant to quality of life as improvements in medical care have helped to preserve vision and extend life expectancy. Although retinal detachment in these eyes is typically rhegmatogenous, the pathophysiology is distinctive due to the association with CMV retinitis which, even in remission, is characterised by atrophic changes at all levels of affected retina and alterations of the vitreous. Despite initially successful surgical reattachment, multiple, small, often posterior holes may develop because of progressive CMV infection. For these reasons, vitrectomy and silicone oil injection with scleral buckling may currently provide the best overall means of maintaining retinal reattachment and restoring visual function. Nevertheless, management must be individualised in each case, with the realisation that progressive visual loss frequently ensues from retinitis progression.
在艾滋病患者中，最重要的眼部机会性感染——巨细胞病毒性视网膜炎，现在可用抗病毒药物有效治疗。常伴有视网膜脱离，随着医疗护理的改善有助于保护视力和延长预期寿命，其治疗对生活质量变得越来越重要。虽然这些眼睛的视网膜脱离通常是孔源性的，但由于与巨细胞病毒性视网膜炎相关，其病理生理学具有独特性，即使在缓解期，受影响的视网膜各层也有萎缩性改变以及玻璃体改变。尽管最初手术复位成功，但由于巨细胞病毒感染进展，可能会出现多个小的、通常是后部的裂孔。由于这些原因，目前玻璃体切除术联合硅油注入及巩膜扣带术可能是维持视网膜复位和恢复视功能的最佳总体方法。然而，必须针对每个病例进行个体化治疗，要认识到视网膜炎进展常常会导致视力逐渐丧失。
