中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2015年
5期
364-368
,共5页
脑膜炎,隐球菌性%获得性免疫缺陷综合征%视乳头水肿%视神经萎缩%巨细胞病毒视网膜炎
腦膜炎,隱毬菌性%穫得性免疫缺陷綜閤徵%視乳頭水腫%視神經萎縮%巨細胞病毒視網膜炎
뇌막염,은구균성%획득성면역결함종합정%시유두수종%시신경위축%거세포병독시망막염
Meningitis,cryptococcal%Acquired immunodeficiency sydrome%Papilledema%Optic atrophy%Cytomegalovirus retinitis
目的 探讨获得性免疫缺陷综合征(AIDS)合并隐球菌性脑膜炎患者眼部表现.方法 回顾性研究.观察40例AIDS合并隐球菌性脑膜炎患者眼部病变特点,其中男性32例,女性8例,男女比例4∶1,年龄11～67岁,平均年龄(38±12)岁,对所有患者均行视力、眼球运动、眼压、裂隙灯显微镜、散瞳间接检眼镜眼底检查及眼底彩色照相.所有患者进行CD4+T淋巴细胞的检测,行腰椎穿刺脑脊液检查.18例患者随访2周至4年5个月,4例患者住院期间死亡,18例患者至外地后失访.结果 3例患者出现双眼复视,为双眼或单眼外展神经麻痹.视乳头水肿共19例(37只眼),1人单眼发病,其中伴视乳头周围出血者为12例(24只眼),不伴出血者为7例(13只眼);出现视神经萎缩者为6例(12只眼),脉络膜病灶为2例(4只眼),眼底正常或仅伴有巨细胞病毒性视网膜炎(CMVR)者为14例(27只眼).结论 AIDS合并隐球菌性脑膜炎患者可伴随多种眼部并发症,其中最常见的为视乳头水肿.
目的 探討穫得性免疫缺陷綜閤徵(AIDS)閤併隱毬菌性腦膜炎患者眼部錶現.方法 迴顧性研究.觀察40例AIDS閤併隱毬菌性腦膜炎患者眼部病變特點,其中男性32例,女性8例,男女比例4∶1,年齡11～67歲,平均年齡(38±12)歲,對所有患者均行視力、眼毬運動、眼壓、裂隙燈顯微鏡、散瞳間接檢眼鏡眼底檢查及眼底綵色照相.所有患者進行CD4+T淋巴細胞的檢測,行腰椎穿刺腦脊液檢查.18例患者隨訪2週至4年5箇月,4例患者住院期間死亡,18例患者至外地後失訪.結果 3例患者齣現雙眼複視,為雙眼或單眼外展神經痳痺.視乳頭水腫共19例(37隻眼),1人單眼髮病,其中伴視乳頭週圍齣血者為12例(24隻眼),不伴齣血者為7例(13隻眼);齣現視神經萎縮者為6例(12隻眼),脈絡膜病竈為2例(4隻眼),眼底正常或僅伴有巨細胞病毒性視網膜炎(CMVR)者為14例(27隻眼).結論 AIDS閤併隱毬菌性腦膜炎患者可伴隨多種眼部併髮癥,其中最常見的為視乳頭水腫.
목적 탐토획득성면역결함종합정(AIDS)합병은구균성뇌막염환자안부표현.방법 회고성연구.관찰40례AIDS합병은구균성뇌막염환자안부병변특점,기중남성32례,녀성8례,남녀비례4∶1,년령11～67세,평균년령(38±12)세,대소유환자균행시력、안구운동、안압、렬극등현미경、산동간접검안경안저검사급안저채색조상.소유환자진행CD4+T림파세포적검측,행요추천자뇌척액검사.18례환자수방2주지4년5개월,4례환자주원기간사망,18례환자지외지후실방.결과 3례환자출현쌍안복시,위쌍안혹단안외전신경마비.시유두수종공19례(37지안),1인단안발병,기중반시유두주위출혈자위12례(24지안),불반출혈자위7례(13지안);출현시신경위축자위6례(12지안),맥락막병조위2례(4지안),안저정상혹부반유거세포병독성시망막염(CMVR)자위14례(27지안).결론 AIDS합병은구균성뇌막염환자가반수다충안부병발증,기중최상견적위시유두수종.
Objective Analysis ophthalmic manifestations in acquired immune deficiency syndrome(AIDS) patients with cryptococcal meningitis.Methods Retrospective study.Forty AIDS patients (including 32 men and 8 women) with cryptococcal meningitis were studied.The age of the patients varied from 11 to 67 years,average on (38 ± 12) years (mean ± standard deviation).All the patients underwent detailed ocular examinations including corrected visual acuity,eye movement,intraocular pressure,slit lamp microscope,indirect ophthalmoscope and color fundus photography.The CD4+ T cell count was evaluated and Lumbar puncture was done to examine the cerebral spinal fluid(CSF).Eighteen patients were followed up for a period between 2weeks to 4years.Four patients died during hospitalization.The remaining 18 patients failed to be followed up due to moving away.Results Binocular diplopia were present in 3 patients.It showed Binocular or monocular abducens nerve palsy.Papilledema were found in 37 eyes of 19 cases.One person had unilateral papilledema.Among 19 cases,24 eyes of 12 cases were accompanied with peripapillary hemorrhages and 7 cases of 13 eyes without peripapillary hemorrhages.Optic atrophy occurs in 6 cases of 12 eyes and multifocal choroiditis in 2 cases of 4 eyes.Twenty-seven eyes of 14 patients had normal fundus or cytomegalovirus retinitis(CMVR) only.Conclusions AIDS patients with cryptococcal meningitis merger may be accompanied by a variety of eye complications.Papilledema are the most common manifestations.
