慢性疱疹性视网膜炎：临床特征和长期预后。

Chronic Herpetic Retinitis: Clinical Features and Long-Term Outcomes.

机构信息

a Ophthalmology Department , Reference Centre for Rare Diseases, Pitié-Salpêtrière Hospital, University Paris VI , Paris , France.

b Laboratory of Virology, Cochin Hospital, University Paris V , Paris , France.

出版信息

Ocul Immunol Inflamm. 2018;26(1):94-103. doi: 10.1080/09273948.2017.1327079. Epub 2017 Jun 19.

DOI:10.1080/09273948.2017.1327079

PMID:28628343

Abstract

INTRODUCTION

Chronic uveitis treated with immunosuppressive agents may have unfavorable outcomes due to delays in diagnosis. The aim of this study was to review initial data from clinical and ocular assessments and patient outcomes following specific treatments for atypical herpes virus ocular infections.

METHODS

The records of four consecutive patients with recurrent uveitis for at least five years treated in our department between 2001 and 2016 were retrospectively reviewed. They had atrophic retinal lesions resulting in an unfavorable outcome with lesion progression and vision loss under immunosuppressive treatment. Varicella zoster virus (1 case) and herpes simplex virus type 2 (3 cases) were detected in ocular samples.

RESULTS

Uveitis was granulomatous and bilateral (3 cases) or unilateral (1 case). Immunosuppressive treatments worsened the clinical situation whereas antiherpetic treatments improved the control of intraocular inflammation.

CONCLUSION

This description should be added to the broad repertoire of clinical polymorphisms associated with herpes virus infections. Recognizing these cases should be useful due to their sensitivity to antiherpetic treatments.

摘要

简介

由于诊断延误，接受免疫抑制剂治疗的慢性葡萄膜炎可能出现不良结局。本研究旨在回顾 2001 年至 2016 年间在我科接受治疗的 4 例复发性葡萄膜炎（至少 5 年）患者的初始临床和眼部评估数据以及患者结局，这些患者存在由于病变进展和免疫抑制治疗导致的视力丧失而导致不良结局的萎缩性视网膜病变。在眼部样本中检测到水痘带状疱疹病毒（1 例）和单纯疱疹病毒 2 型（3 例）。

方法

回顾性分析了 2001 年至 2016 年间在我科接受治疗的 4 例复发性葡萄膜炎（至少 5 年）患者的临床资料，这 4 例患者均为单侧或双侧（3 例）出现萎缩性视网膜病变导致不良结局的患者。葡萄膜炎为肉芽肿性，且为单侧（1 例）或双侧（3 例）。免疫抑制治疗使临床病情恶化，而抗病毒治疗改善了眼内炎症的控制。