目的：探讨获得性免疫缺陷综合征（acquired immune deficiency syndrome, AIDS）合并巨细胞病毒性视网膜炎（cytomegalovirus retinitis，CMVR）抗病毒治疗后眼内液特征，为临床优化治疗方案、评估疗效提供参考。方法：回顾性分析2018年11月—2024年12月广州医科大学附属市八医院收治的49例AIDS合并CMVR患者的临床资料，按治疗方式的不同分为全身用药组（n=23，30眼）及联合组（n=26，30眼），全身用药组予静脉滴注膦甲酸钠全身抗病毒治疗，联合组在此基础上加用玻璃体腔注射更昔洛韦，比较两组的眼内液特征。结果：治疗后两组眼内液CMV核酸载量、白细胞介素（interleukin, IL）-6、IL-8、IL-10、血管内皮生长因子（vascular endothelial growth factor, VEGF）、碱性成纤维细胞生长因子（basic fibroblast growth factor，BFGF）、血管细胞黏附分子（vascular cell adhesion molecule, VCAM）水平低于治疗前，且联合组低于全身用药组（P＜0.05）；治疗前后两组均未检出单纯疱疹病毒（herpes simplex virus, HSV）、水痘-带状疱疹病毒（varicella-zoster virus, VZV）、爱泼斯坦-巴尔病毒(epstein-barr virus, EBV)、人疱疹病毒6型（human herpesvirus 6, HHV-6）。Spearman秩相关分析显示，房水中CMV核酸载量与IL-6、IL-8、IL-10、VEGF、BFGF、VCAM均呈正相关（P＜0.05）。结论：AIDS合并CMVR患者经全身联合局部抗病毒的疗效更佳，可更显著降低眼内液CMV核酸载量及相关炎症、生长因子水平，且房水CMV核酸载量与上述细胞因子水平呈正相关系。

Objective: To investigate the intraocular fluid characteristics of acquired immunodeficiency syndrome (AIDS) complicated with cytomegalovirus retinitis (CMVR) after antiviral treatment. Method: A retrospective analysis was conducted on the clinical data of 49 patients with AIDS and concomitant CMVR admitted to our hospital from November 2018 to December 2024. They were divided into a control group (n=23, 30 eyes) and a combination group (n=26, 30 eyes) according to different treatment methods. The control group received systemic antiviral treatment with intravenous sodium phosphonate, while the combination group received intravitreal injection of ganciclovir (GCV) on this basis. The intraocular fluid characteristics of the two groups were compared. Result: After treatment, the levels of CMV nucleic acid load, interleukin-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (BFGF), and vascular cell adhesion molecule (VCAM) in the intraocular fluid of both groups were lower than before treatment, and the combined group was lower than the control group (P<0.05); No HSV was detected in both groups before and after treatment EBV、VZV、HHV-6。 Spearman correlation analysis showed that the CMV nucleic acid load in aqueous humor was positively correlated with IL-6, IL-8, IL-10, VEGF, BFGF, and VCAM (P<0.05). Conclusion: AIDS patients with CMVR showed better efficacy after systemic and local antiviral treatment, and exhibited significant decreases in CMV nucleic acid load and related cytokines in aqueous humor.

报道1例人类免疫缺陷病毒(human immunodeficiency virus，HIV)眼部巨细胞病毒性视网膜炎(cytomegalovirus retinitis，CMVR)合并脉络膜结核瘤感染患者，主因双眼视物模糊2周就诊。经眼部检查发现右眼底颞侧视网膜广泛黄白色颗粒样病变，病灶边界可见黄白色奶酪样渗出，左眼下方视网膜大片黄白色渗出伴出血。在随访半年后发现左眼视网膜脉络膜隆起病灶，根据其全身及眼部临床特征，诊断为双眼CMVR伴左眼脉络膜结核瘤，予全身抗病毒及结核治疗后随访1年余，全身情况及眼部病灶稳定。

A case of human immunodeficiency virus (HIV) cytomegalovirus retinitis (CMVR) complicated with choroidal tuberculoma infection was reported. The patient visited hospital due to bilateral blurred vision for 2 weeks. Ocular examination showed extensive yellowish-white granular lesions in the temporal retina of the right fundus, with yellowish-white cheese-like exudation at the border of the lesion, and a large yellowish-white exudation with hemorrhage at the lower part of the left eye’s retina. After six months of follow-up, the patient was found to have a retinal choroid hump in the left eye. Based on her systemic and ocular clinical features, the patient was diagnosed as bilateral CMVR with choroidal tuberculoma of the left eye. The patient had her follow up check-up a year after her systemic antiviral and anti-tuberculosis treatment with her general condition stable and ocular lesions treated.