Glasgow B J
Department of Ophthalmology, University of California, Los Angeles School of Medicine, USA.
Ophthalmology. 1997 May;104(5):753-60. doi: 10.1016/s0161-6420(97)30237-1.
The author studied the retinal vasculature in patients with acquired immune deficiency syndrome (AIDS) by infusion of microspheres impregnated with fluorescent dye.
Experimental study of the structural integrity of the retinal microvasculature in 14 autopsy patients with AIDS was compared with age- and gender-matched control retinas.
Fourteen autopsy eyes from patients with AIDS, eight autopsy eyes from immunosuppressed control patients, and four autopsy eyes from nonimmunosuppressed control patients were studied.
The central retinal arteries of autopsy eyes were perfused with fluorescent microspheres of 10 and 200 nm in diameter. The retinas were dissected from the eyes and viewed by fluorescence microscopy.
Vascular breaches permeable to 200-nm microspheres were discovered in eyes from patients with AIDS. Ruptured microaneurysms were identified at the center of retinal hemorrhages in 7 of 14 eyes from patients with AIDS and 5 of 8 immunosuppressed control eyes. Leakage around microaneurysms occurred even in the absence of hemorrhage and were more frequent in eyes from patients with AIDS (11/14) than in control eyes (3/12). Cotton wool patches were surrounded by tortuous retinal vessels and microaneurysms.
Ruptured microaneurysms are a frequent cause of retinal hemorrhage in immunosuppressed patients. Breaches in microaneurysms occur even in the absence of hemorrhage. These breaches are often at least 200 nm in diameter, a size that is permissive to capsids and virions of cytomegalovirus (CMV). Ruptured and/or leaky microaneurysms are potential sources of CMV permeation of the blood-retinal barrier. Breaches of the retinal microvasculature are not specific to patients with AIDS and occur frequently in other immunosuppressed patients.
作者通过注入浸渍荧光染料的微球，研究获得性免疫缺陷综合征（艾滋病）患者的视网膜血管系统。
对14例艾滋病尸检患者的视网膜微血管结构完整性进行实验研究，并与年龄和性别匹配的对照视网膜进行比较。
研究了14只艾滋病患者的尸检眼、8只免疫抑制对照患者的尸检眼和4只非免疫抑制对照患者的尸检眼。
向尸检眼的视网膜中央动脉灌注直径为10和200纳米的荧光微球。将视网膜从眼中取出，通过荧光显微镜观察。
在艾滋病患者的眼中发现了可透过200纳米微球的血管破裂处。在14例艾滋病患者的眼中，有7例在视网膜出血中心发现了破裂的微动脉瘤，8例免疫抑制对照眼中有5例发现了破裂的微动脉瘤。即使在没有出血的情况下，微动脉瘤周围也会发生渗漏，且艾滋病患者眼中（11/14）比对照眼中（3/12）更常见。棉絮斑周围有迂曲的视网膜血管和微动脉瘤。
破裂的微动脉瘤是免疫抑制患者视网膜出血的常见原因。即使在没有出血的情况下，微动脉瘤也会出现破裂。这些破裂处的直径通常至少为200纳米，这一尺寸允许巨细胞病毒（CMV）的衣壳和病毒粒子通过。破裂和/或渗漏的微动脉瘤是CMV渗透血视网膜屏障的潜在来源。视网膜微血管破裂并非艾滋病患者所特有，在其他免疫抑制患者中也经常发生。
