Chen Chao, Guo Chun-Gang, Meng Li, Yu Jing, Xie Lian-Yong, Dong Hong-Wei, Wei Wen-Bin
Beijing You An Hospital, Capital Medical University, Beijing 100069, China.
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Int J Ophthalmol. 2017 Sep 18;10(9):1396-1401. doi: 10.18240/ijo.2017.09.11. eCollection 2017.
To compare the clinical manifestation of cytomegalovirus (CMV) retinitis and microvascular retinopathy (MVR) in patients with acquired immunodeficiency syndrome (AIDS) in China.
A total of 93 consecutive patients with AIDS, including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed. Highly active antiretroviral therapy (HAART) status was recorded. HIV and CMV immunoassay were also tested. CD4+ T-lymphocyte count and blood CMV-DNA test were performed in all patients. Aqueous humor CMV-DNA test was completed in 39 patients. Ophthalmological examinations including best corrected visual acuity (BCVA, by International Standard Vision Chart), intraocular pressure (IOP), slit-lamp biomicroscopy, indirect ophthalmoscopy were performed.
In MVR group, the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13. Blood CMV-DNA was 0 (0, 269 000) and 42 patients (80.77%) did not receive HAART. In CMV retinitis group, 13 patients (31.71%) had anterior segment abnormality. The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470 (0, 1 450 000). Nineteen patients (46.34%) had not received HAART. MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%, respectively. Two patients with MVR progressed to CMV retinitis during the follow-up period.
In comparison of CMV, patients with MVR have relatively mild visual function impairment. Careful ophthalmological examination and close follow-up are mandatory, especially for patients who have systemic complications, positive CMV-DNA test and without received HAART.
比较中国获得性免疫缺陷综合征（AIDS）患者中巨细胞病毒（CMV）视网膜炎和微血管性视网膜病变（MVR）的临床表现。
回顾性分析93例连续的AIDS患者，其中41例为CMV视网膜炎患者，52例为MVR患者。记录高效抗逆转录病毒治疗（HAART）状态。检测HIV和CMV免疫分析。对所有患者进行CD4 + T淋巴细胞计数和血液CMV-DNA检测。39例患者完成房水CMV-DNA检测。进行眼科检查，包括最佳矫正视力（BCVA，采用国际标准视力表）、眼压（IOP）、裂隙灯显微镜检查、间接检眼镜检查。
MVR组所有患者前段检查正常，平均BCVA为0.93±0.13。血液CMV-DNA为0（0，269 000），42例患者（80.77%）未接受HAART。CMV视网膜炎组13例患者（31.71%）有前段异常。平均BCVA为0.64±0.35，血液CMV-DNA为3470（0，1 450 000）。19例患者（46.34%）未接受HAART。MVR组和CMV视网膜炎组房水CMV-DNA阳性率分别为0和50%。2例MVR患者在随访期间进展为CMV视网膜炎。
与CMV相比，MVR患者的视功能损害相对较轻。必须进行仔细的眼科检查和密切随访，尤其是对于有全身并发症、CMV-DNA检测阳性且未接受HAART的患者。
