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HIV 阴性巨细胞病毒性视网膜炎的挑战——病例报告。

Challenges in HIV-Negative Cytomegalovirus Retinitis - case report.

机构信息

Ophthalmology Department, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania.

"Carol Davila" University of Medicine and Farmacy Bucharest, Romania.

出版信息

Rom J Ophthalmol. 2021 Jul-Sep;65(3):247-254. doi: 10.22336/rjo.2021.49.

Abstract

We present the case of a 20-year-old girl with severe combined seronegative immunodeficiency who developed a bilateral decrease in visual acuity due to retinal necrosis. After further investigations, increased serological viral levels of Cytomegalovirus (CMV) were detected and confirmed the diagnosis of CMV retinitis in both eyes. After three weeks of systemic therapy with oral valganciclovir, her condition improved, with the best corrected visual acuity of the most affected eye changing from finger counting at presentation to 6/ 12. Although financial matters determined her to discontinue the antiviral treatment after three months, her ophthalmological status remained stable, and she resumed therapy after four weeks of pause. At the four months follow-up, despite an unchanged visual function, her general condition deteriorated. In the absence of appropriate treatment for her immunodeficiency both the patient's ophthalmological and systemic prognosis were poor.

摘要

我们报告了一例 20 岁女性,患有严重联合免疫缺陷,因视网膜坏死导致双侧视力下降。进一步检查发现巨细胞病毒(CMV)血清学病毒水平升高,确诊双眼 CMV 视网膜炎。经口服缬更昔洛韦系统治疗 3 周后,患者病情改善,受累最重眼的最佳矫正视力由就诊时的指数提高至 6/12。尽管经济因素导致她在 3 个月后停止抗病毒治疗,但她的眼科状况保持稳定,停药 4 周后恢复治疗。4 个月随访时,尽管视力无变化,但患者一般状况恶化。由于缺乏针对免疫缺陷的适当治疗,患者的眼科和全身预后均不佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4515/8697781/403f8f6d1e10/RomJOphthalmol-65-247-g001.jpg

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