Hooymans J M, Sprenger H G, Weits J
Department of Ophthalmology, University Hospital, Groningen, The Netherlands.
Doc Ophthalmol. 1987 Sep-Oct;67(1-2):5-12. doi: 10.1007/BF00142691.
A 31-year-old homosexual man with AIDS, bilateral cytomegalovirus (CMV) retinitis and optic neuritis in one eye, was treated with DHPG. The drug is an acyclic nucleoside analogue of guanosine with antiviral activity. The visual acuity at the start of treatment was R.E.: no light perception and L.E.: 1.25. There was bilateral regression of retinal exudates on DHPG 5 mg/kg twice a day during 2 weeks. The visual result however was poor because of the optic nerve involvement, which did not improve during DHPG treatment. Four weeks later there was a recurrence of retinitis with the development of exudative retinal detachment in the eye with optic neuritis, despite maintenance therapy of 5 mg/kg once a day Monday through Friday. The dose was increased to 5 mg/kg twice a day, but after 1 week treatment had to be discontinued because of neutropenia. Eight days later treatment was restarted with DHPG 5 mg/kg in a single daily dose during 17 days, which led to remission of retinitis but retinal reattachment did not occur. Thereafter maintenance therapy was continued. Visual acuity remained unchanged. DHPG appears to be effective in treating cytomegalovirus retinitis but long-term suppressive therapy would be necessary to prevent recurrence of the retinitis.
一名31岁的艾滋病同性恋男性，患有双侧巨细胞病毒（CMV）视网膜炎且一只眼睛患有视神经炎，接受了更昔洛韦（DHPG）治疗。该药物是一种具有抗病毒活性的鸟苷无环核苷类似物。治疗开始时的视力为：右眼无光感，左眼1.25。在两周内每天两次给予5mg/kg更昔洛韦治疗期间，双侧视网膜渗出物消退。然而，由于视神经受累，视觉效果不佳，在更昔洛韦治疗期间没有改善。四周后，尽管周一至周五每天一次给予5mg/kg维持治疗，但视神经炎眼出现视网膜炎复发并伴有渗出性视网膜脱离。剂量增加到每天两次5mg/kg，但1周后因中性粒细胞减少不得不停药。八天后，以每天一次5mg/kg更昔洛韦重新开始治疗，持续17天，这导致视网膜炎缓解，但视网膜未重新附着。此后继续维持治疗。视力保持不变。更昔洛韦似乎对治疗巨细胞病毒视网膜炎有效，但需要长期抑制治疗以预防视网膜炎复发。
