Objective To investigate the clinical features of acquired immune deficiency syndrome( AIDS ) patients with cytomegalovirua( CMV )retinitis and its relationship with CD4 + T cell count. Methods We examined the fundus of HIV/AIDS patients by indirect ophthalmoscopy, and analyzed the clinical symptoms and CD4 + T cell count of patients who were diagnosed with CMV retinitis. Results 73 patients were found with CMV retinitis in 449 HIV/AIDS patients, the rates of which were 16.26% , included 28 patients with one eye involved and 45 patients with two eyes involved. The vision of 61 patients was changed, the rates of which were 83.56%. The fundus manifestations included yellow-white lesions along vascular distribution and hemorrhage of retina. The vitreum was rarely involved. The incidence of CMV retinitis in patients with CD4 + T cell count below 50 cell/u,l was significantly higher than that in the patients with CD4+ T cell count above 50 cell/μl ( P < 0. 05 ). Conclusion CMV retinitis usually occurs in late-stage AIDS patients. Most of HIV/AIDS patients have fundus change without vision change. Routine fundus examination is important to improve the prognosis of CMV retinitis in the patients with low CD4+T cell count but without ocular symptoms.%目的 探讨获得性免疫缺陷综合征(AIDS)合并巨细胞病毒性视网膜炎的临床特点及其与CD4+T细胞计数关系.方法 对449例HIV/AIDS病人进行间接检眼镜检查,并对其中合并巨细胞病毒性视网膜炎73例患者的临床表现、眼底改变及CD4+T细胞计数进行分析.结果 449例HIV/AIDS病人中检出巨细胞病毒性视网膜炎73例,检出率为16.26%,其中单眼受累28例,双眼受累45例;有视力改变61例,占83.56%.眼底表现为沿血管分布的黄白色病理改变,伴有片状出血,很少累及玻璃体.449例患者中CD4+T细胞计数≤50个/μl的患者巨细胞病毒性视网膜炎检出率为19.74%(45/228),明显高于CD4+T细胞计数＞50个/μl患者的12.67%(28/221)(P＜0.05).结论 巨细胞病毒性视网膜炎多发生于AIDS晚期患者,多数患者视力未发生改变时,其眼底早就发生病变,对CD4+T细胞低下而眼部无症状的AIDS患者应常规行眼底镜检查,对于改善巨细胞病毒性视网膜炎的预后有重要意义.
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