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愛滋病患合併巨細胞病毒視網膜炎之眼底表徵－病例報告
The Eye Fundus Manifestations of Cytomegaloviurs Retinitis in Aids-3 Case Report
摘要
巨細胞病毒視網膜炎(Cytomegalovinus retinitis)是造成愛滋病患者眼部最常見的機緣性感染。本文報告三例愛滋病患者合併巨細胞病毒視網膜炎，且以不同型態之眼底表徵表現。 病例一為發生在眼球後極部之典型巨細胞病毒視網膜炎。左眼視力為1/60，檢查發現廣泛性視網膜壞死，出血，及水腫，血管大量滲出物，視神經盤水腫，其病灶就如同像是”pizza pie”及”crumbled cheese and ketchup”。 病例二為發生在週邊視網膜之初期巨細胞病毒視網膜炎。兩眼矯正後視力皆可達6/6，檢查發現右眼週邊視網膜有一顆粒狀黃白相間的壞死病灶。眼底螢光血管攝影(fluorescein angiography)發現視網膜血管有不正常滲漏現象，且在晚期攝影時有螢光染劑滲出。 病例三為巨細胞病毒視網膜炎末期之臨床病徵。兩眼視力均為20公分辨別指數，兩眼眼底均有廣泛性現網膜壞死，出血，及色素變化所造成視網膜退化現象。視神經盤也萎縮，變白，合併嚴重的血管白鞘化(vessel sheathing)，造成永久性視力喪失。
關鍵字
無資料並列摘要
Cytomegalovirus (CMV) retinitis is the most common ocular infection in patients with the acquired immunodeficiency syndrome (AIDS). This progressive ocular infection is destructive, since blindness results if left untreated. We report 3 AIDS patients with CMV retinitis, representing different clinical eye fundus manifestations. Case 1 represents the typical lesion of CMV retinitis, which is located at posterior pole. The findings of left eye fundus revealed large retinal necrosis areas with retinal hemorrhage, diffuse edema and, in particular, optic disc swelling, which looked like pizza pie or ”crumbled cheese and ketchup”. Case 2 represents a peripheral early retinal lesion of CMV retinitis. The patient has no any complaint of vision change (VA:6/6, ou). It appeared early as yellowish and white granular foci at the midperipheral of right eye. The fluorecein angiography revealed a patch hyperfluorecence and fluffy margin in peripheral retina of the right eye. Case 3 represents the end stage of CMV retinitis. The bilateral eye fundus examination showed diffuse retinal necrosis, mottling appearance of retinal pigment epithelium, severe disc atrophy, and nearly total vessel sheathing and occlusion.
延伸閱讀
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