AIDS相关性巨细胞病毒性视网膜炎患者更昔洛韦埋植剂治疗的相关预后研究  

Outcomes Associated with Ganciclovir Implants in Patients with AIDS-Related Cytomegalovirus Retinitis

作　　者：Kappel P.J. Charonis A.C. Holland G.N. 刑咏新 

机构地区：[1]Ocular Inflammatory Disease Center,Jules Stein Eye Institute,Department of Ophthalmology,Los Angeles,CA,United States Dr.

出　　处：《世界核心医学期刊文摘（眼科学分册）》2006年第10期49-50,共2页Digest of the World Core Medical Journals:Ophthalmology

摘　　要：Purpose:To investigate complications associated with ganciclovir implants used to treat AIDS-related cytomegalovirus(CMV)retinitis,and to identify factors that predict poor outcomes.Design:Retrospective chart review.Participants:Consecutive patients with AIDS-related CMV retinitis from 3 clinical facilities who underwent implantation procedures during the period January 1,1995 through December 31,2001.Methods:Baseline for each patient was the date of the first implantation procedure performed during the study period by one of the facilities’surgeons(index implant).Medical and ophthalmological data were collected at baseline and at specific time points after baseline.The dates on which additional implantation procedures were performed and the dates on which complications or vision loss were identified were also recorded.Relationships between potential risk factors and outcomes were studied by Kaplan-Meier analyses and Cox proportional hazards regression models.Main Outcome Measures:Primary outcome measures included postoperative complications specifically related to or possibly related to ganciclovir implants.A secondary outcome measure was vision loss after implantation procedures.Results:The charts of 174 patients(one study eye per patient;279 implants)were reviewed.Median follow-up was 14.4 months(range,0-7 years).Complications specifically related to implants occurred throughout follow-up at a rate of 0.064 events per patient-year.Complications possibly related to implants occurred at an overall rate of 0.377 per patient-year,but seemed to be more common during the first 2 years after baseline.During the first 2 years of followup,retinal detachments occurred at a rate of 0.156 events per patient-year.The cumulative risk of vision loss(≥ 3 lines of Snellen visual acuity)at 7 years was 70%.Poor outcomes were associated with disease factors(size and activity of lesions),lack of highly active antiretroviral therapy(HAART),and lack of HAART-associated immune reconstitution,but not with surgical factors or implaPurpose:To investigate complications associated with ganciclovir implants used to treat AIDS-related cytomegalovirus(CMV)retinitis,and to identify factors that predict poor outcomes.Design:Retrospective chart review.Participants:Consecutive patients with AIDS-related CMV retinitis from 3 clinical facilities who underwent implantation procedures during the period January 1,1995 through December 31,2001.Methods:Baseline for each patient was the date of the first implantation procedure performed during the study period by one of the facilities'surgeons(index implant).Medical and ophthalmological data were collected at baseline and at specific time points after baseline.The dates on which additional implantation procedures were performed and the dates on which complications or vision loss were identified were also recorded.Relationships between potential risk factors and outcomes were studied by Kaplan-Meier analyses and Cox proportional hazards regression models.Main Outcome Measures:Primary outcome measures included postoperative complications specifically related to or possibly related to ganciclovir implants.A secondary outcome measure was vision loss after implantation procedures.Results:The charts of 174 patients(one study eye per patient;279 implants)were reviewed.Median follow-up was 14.4 months(range,0-7 years).Complications specifically related to implants occurred throughout follow-up at a rate of 0.064 events per patient-year.Complications possibly related to implants occurred at an overall rate of 0.377 per patient-year,but seemed to be more common during the first 2 years after baseline.During the first 2 years of followup,retinal detachments occurred at a rate of 0.156 events per patient-year.The cumulative risk of vision loss(≥ 3 lines of Snellen visual acuity)at 7 years was 70%.Poor outcomes were associated with disease factors(size and activity of lesions),lack of highly active antiretroviral therapy(HAART),and lack of HAART-associated immune reconstitution,but not with surgical factors or implant

关 键 词：埋植剂 视网膜炎 预后研究 巨细胞病毒 免疫重建 免疫缺陷 病历分析 手术日期 视网膜脱离 患者病历 

分 类 号：R774.1[医药卫生—眼科]