Retinite herpética em pacientes com AIDS

Herpetic retinitis in patients with AIDS

RESUMO

Objetivo:

Estudar a incidência e as formas de retinite herpética em pacientes com a síndrome da imunodeficiência adquirida (AIDS).

Material e Métodos:

Estudo retrospectivo de pacientes com diagnóstico de AIDS e retinite herpética no período de janeiro de 1992 a janeiro de 1997.

Resultados:

Do total de 1450 pacientes com diagnóstico de AIDS, 51 tinham também o diagnóstico de retinite herpética sendo 29 (57%) com necrose aguda da retina (ARN) e 22 (43%) com necrose progressiva da retina externa (PORN).Dos 29 pacientes (40 olhos) com ARN; 28 (96%) eram do sexo masculino. Dos 40 olhos foi observado acometimento unilateral em 24 (60%) e bilateral em 8 (40%), baixa de acuidade visual em 36 (90%), inflamação de segmento anterior em 28 (70%). precipitados ceráticos em 15 (37,5%), sinéquias posteriores em 8 (20%) e células vítreas em 21 (52,5%) olhos. Comprometimento do nervo óptico ocorreu em 7 (17,5%) olhos e alterações vasculares retinianas em 36 (90%) olhos. Dos 22 pacientes (25 olhos) com PORN, 20 (95%) eram do sexo masculino. Dos 25 olhos foi observado acometimento unilateral em 17 (68%) e bilateral em 4 (32%), baixa de acuidade visual em 18 (82%), inflamação do segmento anterior em 8 (36%), sinéquias posteriores em 2 (9%) e células vítreas em 6 (27,7%) olhos. Houve envolvimento de nervo óptico em 4 (18%) olhos.

Conclusão:

A retinite herpética é rara, ocorrendo em 3,5% dos pacientes com AIDS no período estudado, sendo a forma mais comum a necrose aguda de retina (2,0%) e a seguir, a síndrome da necrose progressiva da retina externa (1,5 %).

Palavras-chaves:
Retinite herpética; AIDS

SUMMARY

Purpose:

To study the incidence and clinical findings of herpetic retinitis in patients with acquired immunodeficiency syndrome (AIDS).

Material and Methods:

Retrospective study of patients with a diagnosis of AIDS and herpetic retinits, between January 1992 and January 1997.

Results:

Of 1,450 patients with a diagnosis of AIDS, 51 had a diagnosis of herpetic retinitis of which 29 (57%) with acute retinal necrosis (ARN) and 22 (43%) with progressive outer retinal necrosis (PORN). Acute retinal necrosis was present in 29 patients (43%), 28 (96%) of whom were male. It was unilateral in 24 (60%) and bilateral in 8 (40%) of the 40 affected eyes. Decreased visual acuity was found in 36 eyes (90%), anterior chamber inflammation in 28 eyes (70%), keratic precipitates in 15 eyes (37.5%), posterior synechiae in 8 eyes (20%) and vitreous cells in 21 eyes (52.5%). Optic nerve involvement was present in 7 eyes (17.5%) and retinal vasculitis in 36 eyes (92.5%). Progressive outer retinal necrosis (PORN) occurred in 22 patients (43%), 20 (95%) of whom were male. It was unilateral in 17 (68%) patients and bilateral in 4 (32%) of the 25 affected eyes. Decreased visual acuity was noticed in 18 eyes (82%), anterior chamber inflammation in 8 eyes (36%), posterior synechiae in 2 eyes (9%) and vitreous cells in 6 eyes (27. 7%). The optic nerve was involved in 4 eyes (18%).

Conclusion:

Herpetic retinitis was diagnosed in 3.5% of patients with AIDS in the studied period. The acute retinal necrosis was the most common form (2%) followed by the progressive outer retinal necrosis syndrome (1.5%).

Key words:
Herpetic retinitis; AIDS

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Datas de Publicação

• Publicação nesta coleção
  Apr 1998