Cassoux N, Reux I, Guex-Crosier Y, LeHoang P
Service d'ophtalmologie, Groupe hospitalier Pitié-Salpêtrière, Paris.
Rev Prat. 1996 Sep 15;46(14):1745-9.
Cytomegalovirus (CMV) retinitis is the most common retinal opportunistic infection in AIDS patients and is the main cause of blindness. It is generally associated with a CD4+ lymphocyte count below 50/microL. CMV retinitis is often asymptomatic (54% of the cases), frequent ophtalmoscopic screening is very important. Two virostatic drugs (Cymevan and Foscavir) have been approved for the treatment of CMV retinitis. Both are effective in preventing the progression of the lesion within 3 weeks of induction therapy. Long-term use of virostatic maintenance therapy delays the onset of relapses. The differential diagnosis of CMV retinitis are: human immunodeficiency virus retinopathy, varicella-zoster virus retinitis, ocular toxoplasmosis, syphilis, candida endophthalmitis in intravenous drug users, and unfrequently, tuberculosis, choroidal pneumocystosis, intraocular lymphoma.
巨细胞病毒(CMV)视网膜炎是艾滋病患者中最常见的视网膜机会性感染,也是失明的主要原因。它通常与CD4 +淋巴细胞计数低于50/微升有关。CMV视网膜炎通常无症状(54%的病例),因此频繁的眼底镜检查非常重要。两种抗病毒药物(西多福韦和膦甲酸钠)已被批准用于治疗CMV视网膜炎。两者在诱导治疗3周内均能有效预防病变进展。长期使用抗病毒维持治疗可延迟复发的发生。CMV视网膜炎的鉴别诊断包括:人类免疫缺陷病毒视网膜病变、水痘-带状疱疹病毒视网膜炎、眼弓形虫病、梅毒、静脉吸毒者的念珠菌性眼内炎,以及罕见的结核病、脉络膜肺孢子菌病、眼内淋巴瘤。