Bunod Roxane, Miere Alexandra, Zambrowski Olivia, Girard Pierre-Marie, Surgers Laure, Souied Eric H
Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, 40 Avenue de Verdun, 94000, Creteil, France.
Department of Infectious and Tropical Diseases, Hôpital Saint Antoine, AP-HP and UMRS, 1136, Sorbonne Université, F75013, Paris, France.
Am J Ophthalmol Case Rep. 2020 Jul 22;19:100783. doi: 10.1016/j.ajoc.2020.100783. eCollection 2020 Sep.
To report the case 47-year-old patient presenting with severe maculopathy associated with long-term ritonavir treatment.
Observational case report of one patient and literature review.
A 47 year-old Caucasian man presented with progressive bilateral vision loss for the past 5 years. His medical history included Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) coinfection since 1992. He was treated by highly active antiretroviral therapy for 24 years including 4 years of didanosine treatment and 18 years of ritonavir treatment. Bilateral extensive macular atrophy with foveal sparing on the left eye and absence of midperipheral/peripheral retina involvement was confirmed on multimodal imaging and functional testing including swept-source OCT angiography and electroretinography.
Ritonavir associated maculopathy is a scarcely described medication-associated retinopathy. In this case, an extensive macular atrophy (with complete loss of photoreceptor, RPE and choriocapillaris layers) and subsequent cone-rod dysfunction appeared after 18 years of ritonavir exposure.
报告一例47岁患者因长期使用利托那韦治疗出现严重黄斑病变的病例。
对一名患者进行观察性病例报告并进行文献回顾。
一名47岁的白人男性在过去5年中出现进行性双侧视力丧失。他的病史包括自1992年以来的人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）合并感染。他接受了24年的高效抗逆转录病毒治疗，其中包括4年的去羟肌苷治疗和18年的利托那韦治疗。通过包括扫频源光学相干断层扫描血管造影和视网膜电图在内的多模态成像和功能测试，证实了双侧广泛的黄斑萎缩，左眼黄斑中心凹保留，且中周部/周边视网膜未受累。
利托那韦相关性黄斑病变是一种很少被描述的药物相关性视网膜病变。在本病例中，利托那韦暴露18年后出现广泛的黄斑萎缩（光感受器、视网膜色素上皮和脉络膜毛细血管层完全丧失）以及随后的视锥视杆功能障碍。
