Optic nerve axonal pathology is related to abnormal visual evoked responses in AIDS.
Optic nerve axonal pathology is related to abnormal visual evoked responses in AIDS.
复制标题
视神经轴突病理学与艾滋病中异常的视觉诱发反应有关。
DOI：
10.1007/s00401-006-0089-1
复制
发表时间：
2006
影响因子：
12.7
通讯作者：
Shankar,SusarlaKrishna
中科院分区：
文献类型：
--
作者：
Mahadevan,Anita;Satishchandra,Parthasarathy;Prachet,KrishnamurthyKulkarni;Sidappa,NagadenahalliByrareddy;Ranga,Udaykumar;Santosh,Vani;Yasha,ThagadurChickabasavaiah;Desai,Anita;Ravi,Vasanthapuram;Shankar,SusarlaKrishna
HIV/AIDS患者的电生理学研究表明，即使在没有视觉症状的情况下，视觉通路也会发生微妙的变化。但电生理异常的病理相关性在很大程度上还不清楚。本研究试图将4例HIV-1 C分支感染的艾滋病药物未成熟患者生前记录的视觉诱发电位异常与视网膜和视神经眶内部的病理改变联系起来。三名患者没有视力问题，一名患者右眼突然失明。在所有四名患者中，视觉诱发电位均显示不同程度的P100潜伏期延长。在组织学上，视神经轴突细胞骨架的破坏和耗竭是主要的发现，即使在没有明显的视觉功能障碍或感染性视网膜炎的情况下，也有不同程度的髓鞘丢失。在有症状的病例中，轴突丢失最多。视网膜神经节细胞耗竭仅见于两名患者。隐球菌和隐球菌性脉络膜炎对视神经的局部渗透是影响眼睛的唯一机会性感染。视神经的轴突病理似乎与视觉诱发电位记录的异常有关，即使没有明显的临床症状也是如此。机会性感染可能是导致艾滋病患者视神经轴突病理的原因之一。
Electrophysiological studies in subjects with HIV/AIDS demonstrate subtle changes in the visual pathway even in the absence of visual symptoms. But the pathological correlate of the electrophysiological abnormalities is largely unknown. This study attempts to correlate pathological changes in the retina and intraorbital portion of optic nerve in four drug naïve patients of AIDS caused by HIV-1 clade C, who had abnormalities in the visual evoked potentials recorded antemortem. Three had no visual complaints and one patient had sudden loss of vision in the right eye. In all four patients, the visual evoked potentials disclosed variable prolongation of P100 latencies. Histologically axonal cytoskeletal breakdown and depletion in the optic nerves was the cardinal finding with variable myelin loss, even in the absence of overt visual dysfunction, or infective retinitis. The axonal loss was maximal in the symptomatic case. Retinal ganglion cell depletion was seen in only two patients. Sectoral infiltration of the optic nerve by cryptococci and Cryptococcal choroiditis was the only opportunistic infection to involve the eye. Axonal pathology in the optic nerve appears to be related to the abnormalities recorded in visual evoked potentials even in the absence of overt clinical symptoms. Opportunistic infections could be contributing to the axonal pathology in the optic nerve in patients with AIDS.