Rosberger D F, Heinemann M H, Friedberg D N, Holland G N
Department of Ophthalmology, The New York Hospital-Cornell Medical Center, New York, USA.
Am J Ophthalmol. 1998 Mar;125(3):301-5. doi: 10.1016/s0002-9394(99)80135-4.
To report uveitis associated with human immunodeficiency virus (HIV) infection and to suggest guidelines for treatment.
Six HIV-seropositive patients (10 eyes) with anterior or posterior uveitis or both were evaluated. After ineffective prolonged treatment with systemic and topical corticosteroids, specific systemic antiretroviral therapy with zidovudine was initiated in all patients. Aqueous humor was cultured in three eyes of three patients, and vitreous humor was cultured in one eye of one patient.
In all 10 eyes of six patients, there was resolution of inflammation in 10 to 42 days after commencement of treatment with zidovudine (600 to 800 mg/day), despite no or minimal response to corticosteroids. Cultures of aqueous humor from three eyes of three patients and culture of vitreous humor from one eye of one patient were positive for HIV; no other organism was isolated. Systemic evaluation disclosed no other identifiable cause for the uveitis in any patient.
Infection with HIV appears to be a cause of uveitis. A trial of zidovudine may be warranted in HIV-seropositive patients with uveitis that is poorly responsive to corticosteroid treatment when no other cause is identified. The efficacy of other retroviral agents was not determined.
报告与人类免疫缺陷病毒（HIV）感染相关的葡萄膜炎，并提出治疗指南。
对6例HIV血清学阳性且患有前葡萄膜炎、后葡萄膜炎或两者皆有的患者（共10只眼）进行评估。在用全身及局部皮质类固醇进行长期治疗无效后，所有患者均开始使用齐多夫定进行特异性全身抗逆转录病毒治疗。对3例患者的3只眼的房水进行培养，对1例患者的1只眼的玻璃体进行培养。
在6例患者的所有10只眼中，在开始使用齐多夫定（600至800毫克/天）治疗后的10至42天内炎症消退，尽管对皮质类固醇无反应或反应极小。3例患者的3只眼的房水培养以及1例患者的1只眼的玻璃体培养HIV呈阳性；未分离出其他病原体。全身评估未发现任何患者的葡萄膜炎有其他可识别的病因。
HIV感染似乎是葡萄膜炎的一个病因。对于皮质类固醇治疗反应不佳且未发现其他病因的HIV血清学阳性葡萄膜炎患者，可能有必要试用齐多夫定。未确定其他逆转录病毒药物的疗效。
