Hazirolan Dicle, Sungur Gulten, Demir Necati, Kasim Remzi, Duman Sunay
1st Ophthalmology Department, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Eur J Ophthalmol. 2010 Sep-Oct;20(5):925-30. doi: 10.1177/112067211002000518.
To describe the clinical features of an atypical form of viral retinitis in immunocompetent patients.
This was a retrospective noncomparative case series. The charts of 8 patients diagnosed with and treated for focal posterior viral retinitis were reviewed. Clinical and demographic features were evaluated. All the patients had extensive laboratory tests, fundus fluorescein angiography, optical coherence tomography of macula, and polymerase chain reaction of vitreous.
All the patients were referred to our Uveitis Service from other hospitals, as their uveitis symptoms deteriorated in spite of treatment. The mean age of 4 male and 4 female patients was 32.1 years (range, 22-42 years). The mean follow-up period was 10 months (range, 6-18 months). All of the patients had unilateral disease. Polymerase chain reaction analysis of vitreous specimen was positive for herpes simplex virus-1 in 5 patients and varicella zoster virus in 3 patients. Retinitis resolved after systemic acyclovir treatment in all patients.
Viral etiology must be borne in mind in the differential diagnosis of atypical retinitis. It can be a milder form of viral retinitis like focal viral retinitis, as mentioned in this study. The prognosis of this disease is better than the other forms of necrotizing retinopathies involving a larger area of retina.
描述免疫功能正常患者中一种非典型病毒性视网膜炎的临床特征。
这是一项回顾性非对照病例系列研究。对8例诊断为局灶性后部病毒性视网膜炎并接受治疗的患者病历进行了回顾。评估了临床和人口统计学特征。所有患者均进行了广泛的实验室检查、眼底荧光血管造影、黄斑光学相干断层扫描以及玻璃体聚合酶链反应。
所有患者均因尽管接受治疗但葡萄膜炎症状仍恶化而从其他医院转诊至我们的葡萄膜炎科。4例男性和4例女性患者的平均年龄为32.1岁(范围22 - 42岁)。平均随访期为10个月(范围6 - 18个月)。所有患者均为单眼患病。玻璃体标本的聚合酶链反应分析显示,5例患者单纯疱疹病毒-1阳性,3例患者水痘带状疱疹病毒阳性。所有患者经全身阿昔洛韦治疗后视网膜炎均消退。
在非典型视网膜炎的鉴别诊断中必须考虑病毒病因。如本研究所述,它可能是一种较轻形式的病毒性视网膜炎,如局灶性病毒性视网膜炎。这种疾病的预后优于其他累及视网膜较大面积的坏死性视网膜病变形式。