Guyer D R, Jabs D A, Brant A M, Beschorner W E, Green W R
Uveitis and Clinical Immunology Service, Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD 21205.
Arch Ophthalmol. 1989 Jun;107(6):868-74. doi: 10.1001/archopht.1989.01070010890037.
A 55-year-old man with the acquired immunodeficiency syndrome had cytomegalovirus (CMV) retinitis develop in his left eye. The patient declined treatment with ganciclovir but elected to be treated with zidovudine. Two months later his CMV retinitis regressed, and it remained inactive for a total of 9 months. The most likely explanation was zidovudine-mediated improvement in the patient's immune function with subsequent suppression of the CMV retinitis in the left eye. The patient ultimately and preterminally had CMV retinitis develop in his right eye. He subsequently died and his eyes were examined at autopsy. Active CMV retinitis lesions were noted in the right eye while inactive scars were noted in the left eye. Immunoperoxidase staining and in situ hybridization studies demonstrated the presence of CMV in the right eye but not in the left eye. While ganciclovir remains the treatment of choice for CMV retinitis, zidovudine treatment may have a beneficial effect on CMV retinitis in some patients.
一名患有获得性免疫缺陷综合征的55岁男性左眼发生了巨细胞病毒（CMV）视网膜炎。该患者拒绝接受更昔洛韦治疗，但选择接受齐多夫定治疗。两个月后，他的CMV视网膜炎消退，并且在总共9个月的时间里一直未再活动。最可能的解释是齐多夫定介导了患者免疫功能的改善，随后抑制了左眼的CMV视网膜炎。该患者最终在临终前右眼发生了CMV视网膜炎。他随后死亡，并在尸检时对其眼睛进行了检查。右眼发现有活动性CMV视网膜炎病变，而左眼则发现有非活动性瘢痕。免疫过氧化物酶染色和原位杂交研究表明，右眼存在CMV，而左眼不存在。虽然更昔洛韦仍然是CMV视网膜炎的首选治疗药物，但齐多夫定治疗可能对某些患者的CMV视网膜炎有有益作用。
