Sidikaro Y, Silver L, Holland G N, Kreiger A E
UCLA Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles.
Ophthalmology. 1991 Feb;98(2):129-35.
Rhegmatogenous retinal detachments can occur in patients with acquired immune deficiency syndrome (AIDS) and necrotizing retinal infections. Of 68 patients with AIDS and necrotizing retinal infections seen between 1983 and 1987, rhegmatogenous retinal detachments developed in 16 patients (27 eyes). In this group, cytomegalovirus retinopathy was present in 75% (12 of 16) of patients, 18.8% (3 of 16) had probable herpes simplex virus retinopathy, and 6.2% (1 of 16) had toxoplasmic retinochoroiditis. Retinal detachment was bilateral in 68.8% (11 of 16) of patients. The retina was reattached successfully in 91% (10 of 11) of operated eyes. Proliferative vitreoretinopathy was present preoperatively in 95% of these eyes. Seven of 11 operated eyes had initial improvement in visual acuity. However, 5 of 11 continued to lose vision despite successful reattachment. Techniques included pneumatic reattachment, scleral buckle, vitrectomy, and silicone oil injection. Complicated retinal detachments in AIDS patients with rhegmatogenous retinal detachments and necrotizing retinal infections are common and can be repaired, but the prognosis is guarded in many patients.
孔源性视网膜脱离可发生于获得性免疫缺陷综合征（AIDS）患者及坏死性视网膜感染患者。在1983年至1987年间诊治的68例AIDS合并坏死性视网膜感染患者中，16例（27只眼）发生了孔源性视网膜脱离。该组患者中，75%（16例中的12例）存在巨细胞病毒性视网膜炎，18.8%（16例中的3例）可能患有单纯疱疹病毒性视网膜炎，6.2%（16例中的1例）患有弓形体性视网膜脉络膜炎。68.8%（16例中的11例）患者的视网膜脱离为双侧性。91%（11只手术眼中的10只）的手术眼视网膜成功复位。这些眼中95%术前存在增殖性玻璃体视网膜病变。11只手术眼中有7只视力最初有所改善。然而，尽管视网膜成功复位，11只中有5只仍继续丧失视力。所采用的技术包括气体填充复位、巩膜扣带术、玻璃体切除术及硅油注入术。AIDS患者合并孔源性视网膜脱离及坏死性视网膜感染时的复杂性视网膜脱离很常见，且可以修复，但许多患者的预后仍不容乐观。
