重视感染性视网膜疾病诊断治疗中的特殊问题,提高感染性视网膜疾病的诊断治疗水平

摘要

The clinical manifestations of infectious retinal diseases are complicated,especially these result from serious infectious diseases such as acquired immune deficiency syndrome (AIDS),tuberculosis and syphilis infections.It is an important issue to differentiate infectious retinal disease from non-infectious intraocular inflammation in the clinic.It is,therefore,highly desirable to follow a proper steps to reach the correct diagnosis.Complete history review and comprehensive ocular examination remains the first step in diagnosing infectious retinal diseases.Although an array of laboratory and serological tests are available to assist in the diagnosis,some situations may require a diagnostic therapy or a tissue biopsy.Identification of the pathogen and histopathologic examination of the ocular specimen remain to be the gold standard of diagnosis.Initiation a specific and appropriate antimicrobial therapy needs multidisciplinary collaborations including ophthalmologists and infectious specialists.Updated knowledge of general medicine and management of infectious diseases,interdisciplinary collaborations and optimization of treatment processes will improve the diagnosis and treatment of retinal infectious diseases in the future.%感染性视网膜疾病眼底表现复杂,尤其艾滋病、结核、梅毒等严重传染性疾病所致的感染性视网膜疾病,临床表现更是复杂多变.重视感染性视网膜疾病的证据采集,提高其诊断治疗水平是眼底病临床工作面临的一个重要问题.完整的病史是感染性视网膜疾病诊断的重要线索；全面的眼部检查及有针对性的实验室检查是其诊断的重要证据；诊断性治疗有助于进一步验证其诊断；病原体检测和组织病理学检查结果是其确诊的金标准.最终治疗方案的确定需要多学科合作.只有不断更新全科医学知识,掌握感染性疾病诊断治疗进展,认识感染性视网膜疾病的本质规律,多学科配合,优诊疗流程,才能真正提高视网膜感染性疾病的诊治水平.