Friedlander S M, Rahhal F M, Ericson L, Arevalo J F, Hughes J D, Levi L, Wiley C A, Graham E M, Freeman W R
Department of Pathology, University of California, San Diego, La Jolla, USA.
Arch Ophthalmol. 1996 Dec;114(12):1481-5. doi: 10.1001/archopht.1996.01100140679005.
To describe the clinical course of varicella-zoster optic neuropathy preceding acute retinal necrosis in patients with acquired immunodeficiency syndrome.
Case series.
Two tertiary care centers in San Diego, Calif, and London, England.
Three human immunodeficiency virus-positive men with previous cutaneous zoster infection, optic neuropathy, and necrotizing retinitis.
All patients had an episode of zoster dermatitis treated with acyclovir. Visual loss consistent with an optic neuropathy ensued, followed by typical herpetic retinitis. The cause of visual loss was not suspected to be varicella-zoster until after the retinitis occurred. Despite aggressive medical treatment, 4 of 6 eyes progressed to retinal detachment.
Varicella-zoster may cause an optic neuropathy in patients with acquired immunodeficiency syndrome, especially in those with previous shingles. A high index of suspicion is necessary to establish the diagnosis and begin early antizoster treatment.
描述获得性免疫缺陷综合征患者在急性视网膜坏死之前发生的水痘 - 带状疱疹性视神经病变的临床过程。
病例系列。
加利福尼亚州圣地亚哥和英国伦敦的两个三级医疗中心。
三名人类免疫缺陷病毒阳性男性，既往有皮肤带状疱疹感染、视神经病变和坏死性视网膜炎。
所有患者均有一次带状疱疹性皮炎发作，接受了阿昔洛韦治疗。随后出现与视神经病变相符的视力丧失，接着是典型的疱疹性视网膜炎。在视网膜炎发生后才怀疑视力丧失的原因是水痘 - 带状疱疹。尽管进行了积极的药物治疗，6只眼中仍有4只发展为视网膜脱离。
水痘 - 带状疱疹可能导致获得性免疫缺陷综合征患者发生视神经病变，尤其是既往有水痘病史的患者。高度怀疑对于确立诊断和尽早开始抗带状疱疹治疗很有必要。
