Freeman W R, Gross J G, Labelle J, Oteken K, Katz B, Wiley C A
Department of Ophthalmology, University of California San Diego, School of Medicine, La Jolla 92093.
Arch Ophthalmol. 1989 Jun;107(6):863-7. doi: 10.1001/archopht.1989.01070010885036.
A 43-year-old black woman with acquired immunodeficiency syndrome developed bilateral multifocal choroidopathy characterized by slowly enlarging round to oval lesions in the posterior pole and midperiphery. Systemic evaluation revealed no evidence of mycobacterial, fungal, or spirochetal disease. Fluorescein angiography of the lesions showed early hypofluorescence with late staining of the lesions, which appeared deep to the retinal circulation. There was no evidence of retinal involvement. Over a 4-month period of observation, the lesions appeared to enlarge slowly, with no evidence of vitreous cells or debris in the overlying retina. A transscleral choroidal biopsy was performed, and electron microscopy showed numerous cystic structures characteristic of Pneumocystis carinii within necrotic choroid. The lack of inflammatory changes clinically, by fluorescein angiography, and histopathologically was striking.
一名43岁的患有获得性免疫缺陷综合征的黑人女性患上了双侧多灶性脉络膜病变，其特征为后极部和中周边部有逐渐增大的圆形至椭圆形病灶。全身评估未发现分枝杆菌、真菌或螺旋体病的证据。病灶的荧光素血管造影显示早期低荧光，后期病灶染色，病灶似乎位于视网膜循环的深部。没有视网膜受累的证据。在4个月的观察期内，病灶似乎缓慢增大，上方视网膜内没有玻璃体细胞或碎屑的迹象。进行了经巩膜脉络膜活检，电子显微镜检查显示坏死脉络膜内有许多卡氏肺孢子虫特有的囊状结构。临床上、荧光素血管造影及组织病理学上均缺乏炎症改变，这一点很显著。
