Dujić Mirjana, Jevtović Djordje
Srp Arh Celok Lek. 2007 Sep-Oct;135(9-10):513-5. doi: 10.2298/sarh0710513d.
Immune recovery vitritis (IRV) is symptomatic vitritis of > 1 + severity associated with inactive cytomegalovirus (CMV) retinitis. It is an opportunistic infection of the eye, in the patients who suffer from AIDS, and is treated with a highly active antiretroviral therapy (HAART). As a result of this therapy, there is an immune reconstitution in the body and inflammation of the vitreous body.
The aim of the study was to show the incidence of IRV in patients treated with HAART.
A retrospective study was conducted in patients who suffered from CMV retinitis. Twenty-one were treated with HAART and had the diagnosis of CMV retinitis, as well. All of them were examined by the same ophthalmologist who peformed slit lamp examination with mydriasis and indirect ophthalmoscopy.
Nine of 21 patients developed IRV as a complication of HAART, two had cystoid macular oedema (CMO).
CMV retinitis develops when the number of CD4+ T lymphocytes drops below 50/mm3. This results in necrotic retinitis which, if untreated, leads to complete loss of vision. With the introduction of HAART, we learned that the reconstitution of immune status was achieved as well as life expectancy, but there was a dramatic decline in the opportunistic infection, including CMV retinitis, as well. With the immune reconstitution, the inflammation develops in the eye, known as IRV. Sometimes, it is neccessary to treat this condition, but in the case of our patients, the inflammation was mild, and no treatment was neccessary.
免疫重建性葡萄膜炎（IRV）是与静止性巨细胞病毒（CMV）视网膜炎相关的严重程度大于1+的症状性葡萄膜炎。它是艾滋病患者眼部的一种机会性感染，采用高效抗逆转录病毒疗法（HAART）进行治疗。由于这种疗法，体内会发生免疫重建以及玻璃体炎症。
本研究的目的是显示接受HAART治疗的患者中IRV的发生率。
对患有CMV视网膜炎的患者进行了一项回顾性研究。21名患者接受了HAART治疗，同时也被诊断为CMV视网膜炎。他们均由同一位眼科医生进行检查，该医生进行了散瞳裂隙灯检查和间接检眼镜检查。
21名患者中有9名发生IRV，作为HAART的并发症，2名患有黄斑囊样水肿（CMO）。
当CD4 + T淋巴细胞数量降至50/mm3以下时，会发生CMV视网膜炎。这会导致坏死性视网膜炎，如果不进行治疗，会导致视力完全丧失。随着HAART的引入，我们了解到免疫状态得以重建，预期寿命也得以延长，但机会性感染，包括CMV视网膜炎，也显著减少。随着免疫重建，眼部会发生炎症，即IRV。有时，有必要治疗这种情况，但就我们的患者而言，炎症较轻，无需治疗。
