Zegans M E, Walton R C, Holland G N, O'Donnell J J, Jacobson M A, Margolis T P
Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco 94122, USA.
Am J Ophthalmol. 1998 Mar;125(3):292-300. doi: 10.1016/s0002-9394(99)80134-2.
To report the observation that a transient vitreous inflammatory reaction may develop in the eyes of patients with acquired immunodeficiency syndrome (AIDS), cytomegalovirus retinitis, and an increased CD4+ T-lymphocyte count during treatment with antiretroviral therapy including a protease inhibitor.
We reviewed the medical records of eight patients with AIDS and cytomegalovirus retinitis who developed vitreous inflammatory reactions greater than those usually seen with this disease.
Vitreous inflammatory reactions obscured the view of the posterior pole in all patients. No iris nodules, synechiae, glaucoma, or cystoid macular edema were observed. Six patients had unilateral cytomegalovirus retinitis, and, in each, the inflammation occurred only in the eye with cytomegalovirus retinitis. The vitreous inflammatory reactions were associated with clinically inactive cytomegalovirus retinitis in six patients, with disease reactivation in one patient, and were present at diagnosis of active disease in one patient. Cytomegalovirus retinitis has not recurred in any of these patients since their episodes of vitreous inflammation. Vitreous inflammation developed in all eight patients after a substantial increase in CD4+ T-lymphocyte counts caused by combination antiretroviral therapy. Five patients had CD4+ T-lymphocyte counts of greater than 100 cells per microl at the time the vitreous inflammatory reaction developed. No other causes of uveitis were found.
Patients with AIDS and cytomegalovirus retinitis may develop transient intraocular inflammation associated with combination antiretroviral therapy. We believe that this inflammation reflects an improved immune response against cytomegalovirus.
报告一项观察结果，即在获得性免疫缺陷综合征（AIDS）、巨细胞病毒性视网膜炎患者中，接受包括蛋白酶抑制剂在内的抗逆转录病毒治疗期间，若CD4 + T淋巴细胞计数增加，可能会发生短暂性玻璃体炎症反应。
我们回顾了8例患有AIDS和巨细胞病毒性视网膜炎且发生了比该疾病通常所见更严重的玻璃体炎症反应的患者的病历。
所有患者的玻璃体炎症反应均使后极部视野模糊。未观察到虹膜结节、粘连、青光眼或黄斑囊样水肿。6例患者为单侧巨细胞病毒性视网膜炎，且每例患者的炎症仅发生在患有巨细胞病毒性视网膜炎的眼睛中。玻璃体炎症反应在6例患者中与临床静止的巨细胞病毒性视网膜炎相关，在1例患者中与疾病再激活相关，在1例活动性疾病诊断时就已存在。自这些患者发生玻璃体炎症以来，巨细胞病毒性视网膜炎在任何患者中均未复发。在联合抗逆转录病毒治疗导致CD4 + T淋巴细胞计数大幅增加后，所有8例患者均出现了玻璃体炎症。5例患者在发生玻璃体炎症反应时CD4 + T淋巴细胞计数大于每微升100个细胞。未发现葡萄膜炎的其他病因。
患有AIDS和巨细胞病毒性视网膜炎的患者可能会发生与联合抗逆转录病毒治疗相关的短暂性眼内炎症。我们认为这种炎症反映了针对巨细胞病毒的免疫反应改善。
