Abe T, Nakajima A, Satoh N, Koizumi T, Sakuragi S, Ono T, Komatsu M, Masamune O
Department of Ophthalmology, Akita University School of Medicine, Japan.
Jpn J Ophthalmol. 1995;39(4):411-9.
The morbidity rate for retinopathy of unknown origin was significantly higher (P < 0.001) in the chronic hepatitis C group, 27 (31.8%) of 85 cases, than in the control group, 6 (6.0%) of 100 cases. Among hepatitis C virus (HCV)-associated retinopathy patients, 6 cases (22.2%) were aware of ocular subjective symptoms, retinopathy recurred in 8 (29.6%) cases, binocular retinopathy occurred in 14 (51.9%) cases, and retinopathy related to liver dysfunction, in 13 (81.3%) of 16 tested cases. HCV-associated retinopathy involved hemorrhage at the posterior pole retina in 21 (77.8%), cotton-wool patches in 9 (33.3%), and hemorrhage at the peripheral retina in 7 (25.9%) cases. Sequelae occurred in only one case. Retinopathy worsened or recurred in all 7 cases treated with interferon. The risk factors for HCV-associated retinopathy were mild thrombocytopenia (P < 0.001), long-term hepatitis illness (P < 0.005), advanced age (P < 0.02), concurrence with liver cirrhosis (P < 0.02), history of systemic hypertension (P < 0.05), and female gender (P < 0.05).
不明原因视网膜病变的发病率在慢性丙型肝炎组中显著更高(P < 0.001),85例中有27例(31.8%),而在对照组中,100例中有6例(6.0%)。在丙型肝炎病毒(HCV)相关性视网膜病变患者中,6例(22.2%)有眼部主观症状,8例(29.6%)视网膜病变复发,14例(51.9%)为双眼视网膜病变,在16例检测病例中,13例(81.3%)视网膜病变与肝功能障碍有关。HCV相关性视网膜病变累及后极部视网膜出血21例(77.8%)、棉絮斑9例(33.3%)、周边视网膜出血7例(25.9%)。仅1例出现后遗症。用干扰素治疗的所有7例患者视网膜病变均加重或复发。HCV相关性视网膜病变的危险因素为轻度血小板减少(P < 0.001)、长期肝病(P < 0.005)、高龄(P < 0.02)、合并肝硬化(P < 0.02)、系统性高血压病史(P < 0.05)以及女性(P < 0.05)。