巨细胞病毒性视网膜炎伴全视网膜闭塞性血管炎
CMV Retinitis with Panretinal Occlusive Vasculitis.
作者信息
Wang I, Yang Benjamin Chi-Lan, Li Kun-Hsien, Wu Jian-Sheng, Chen San-Ni
机构信息
Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan.
出版信息
Ocul Immunol Inflamm. 2024 Jul;32(5):477-484. doi: 10.1080/09273948.2022.2148113. Epub 2022 Dec 12.
PURPOSE
To report the clinical features of cytomegalovirus (CMV) retinitis with panretinal occlusive vasculitis.
METHODS
Retrospective case series.
RESULTS
Four eyes in 3 non-HIV patients (male: female = 3:0) were included. Previous medical history included diabetes mellitus (n = 2), age-related macular degeneration (n = 1), and Multiple myeloma under chemotherapy (n = 1). All patients were treated with oral valganciclovir and intravitreal ganciclovir. Slow resolution of retinitis related retinal opacification was noted in all 4 eyes. Two eyes had anti-viral agents discontinued despite the persistent retinitis related opacification and the lesions slowly resolved in the following months. The final decimal visual acuity was equal to or worse than 0.02 in 3 of the 4 eyes.
CONCLUSION
In eyes of CMV retinitis with panretinal occlusive vasculitis, rapid resolution of retinitis lesions is an unreliable sign evaluating the therapeutic efficacy of anti-viral agents. Besides, despite treatment of anti-viral agents, deteriorating vascular occlusion may further endanger macular function.
目的
报告合并全视网膜闭塞性血管炎的巨细胞病毒（CMV）视网膜炎的临床特征。
方法
回顾性病例系列研究。
结果
纳入3例非HIV患者的4只眼（男∶女 = 3∶0）。既往病史包括糖尿病（2例）、年龄相关性黄斑变性（1例）和化疗中的多发性骨髓瘤（1例）。所有患者均接受口服缬更昔洛韦和玻璃体内注射更昔洛韦治疗。所有4只眼中均观察到视网膜炎相关视网膜混浊的缓慢消退。2只眼尽管视网膜炎相关混浊持续存在，但抗病毒药物已停用，病变在随后几个月缓慢消退。4只眼中有3只最终小数视力等于或低于0.02。
结论
在合并全视网膜闭塞性血管炎的CMV视网膜炎眼中，视网膜炎病变的快速消退是评估抗病毒药物治疗效果的不可靠指标。此外，尽管进行了抗病毒药物治疗，但血管闭塞的恶化可能会进一步危及黄斑功能。
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