免疫重建性视网膜病变的临床研究

Chinical Study of Immune Reconstitution Retinopathy

摘要: 目的：了解AIDS患者高效抗逆转录病毒治疗(HAART)后，免疫重建性视网膜病变的临床特征。方法：对26例在我院感染科诊断为AIDS的患者在HAART治疗中出现的免疫重建性视网膜病变进行临床分析。结果：26例均有视力下降，眼底表现为巨细胞病毒性视网膜炎，眼底表现为视网膜广泛变白，边缘颗粒状，大片状出血、大量黄白色渗出，伴有全葡萄膜炎。结论：AIDS患者高效抗逆转录病毒治疗(HAART)后，可出现免疫重建性视网膜病变(IRIS)。在病人的诊治上最重要的就是提高对IRIS的鉴别能力，减少延误。

Abstract: Purpose: To determine the clinical features of immune reconstitution retinopathy among HIV-in- fected individuals which were receiving highly active antiretroviral therapy (HAART). Methods: 26 HIV-infected patients who were diagnosed in our department of infectious diseases were chosen. The clinical data of the patients with immune reconstitution retinopathy initiated by highly active antiretroviral therapy (HAART) were retrospectively reviewed. Results: In our series of 26 patients, all patients presented with decreased visual acuity. The most common ocular manifestation was cytomegalovirus retinitis with fundus findings of wide-whitened retina, granular margin, extensive hemorrhage and exudations. All cases were accompanied by panuveitis. Conclusions: Immune reconstitution inflammatory syndrome (IRIS) is a complication caused by reactivation of the immune system that can occur after starting highly active antiretroviral therapy (HAART). Im-proving the ability of identification of IRIS is the most important way to reduce the delays in diag-nosis and treatment.