OCULAR TOXICITY OF 2',3'-DIDEOXYINOSINE

这项名为“2‘，3’-二脱氧肌苷(DDI)的眼毒性”的项目是先前的。 在免疫学实验室上市，但现在是临床项目 布兰奇。DDI是一种目前使用的具有抗逆转录病毒活性的嘌呤类似物 治疗获得性免疫缺陷综合征(艾滋病)患者，两者 成人和儿童，在NIH的临床方案中。这样做的目的是 这项研究是前瞻性地跟踪接受DDI治疗的患者 继发于药物中毒的眼部并发症。95% 有症状(CDC P-2类)HIV感染的儿童参加了一项 评估DDI安全性和抗逆转录病毒活性的I-II期研究。 对100多名接受DDI治疗的儿童进行了检查，其中6名儿童 已经发展成视网膜色素上皮的周边萎缩 DDI疗法。患有DDI相关视网膜病变的眼睛现在已经 做了组织学检查。对这些病变的显微镜检查显示 视网膜色素上皮(RPE)丢失的多个区域，其中一些被 RPE肥大或色素减退的区域。部分损失 脉络膜毛细血管和神经感觉性视网膜也在疾病的区域被发现。 RPE。透射电子显微镜显示有许多膜 RPE细胞内有板层包裹体和胞浆小体。这些数据应该 Ddanosine主要影响RPE，绒毛膜毛细血管和 在RPE丢失的区域，覆盖的神经感觉性视网膜也营养不良。我们 也继续跟踪一组75名接受DDI治疗的成年人，定期 眼底检查和眼电检查。一只先前发育的成体 使用DDI治疗时视网膜损害，但没有额外的成人患者 发展成视网膜损伤。

This project, "Ocular toxicity of 2',3'-Dideoxyinosine (ddI)", was previous listed in the Laboratory of Immunology but is now a project in the Clinical Branch. ddI is a purine analog with antiretroviral activity currently used to treat patients with the acquired immunodeficiency syndrome (AIDS), both adults and children, in clinical protocols at the NIH. The purpose of this study is to prospectively follow patients treated with ddI for the development of ocular complications secondary to drug toxicity. Ninety-fiv children with symptomatic (CDC class P-2) HIV infection were enrolled in a Phase I-II study to assess the safety and antiretroviral activity of ddI. More than 100 children treated with ddI have been examined, and 6 children have developed peripheral atrophy of the retinal pigment epithelium during ddI therapy. Eyes with ddI-associated retinal lesions have now been examined histologically. Microscopic examination of these lesions revealed multiple areas of retinal pigment epithelial (RPE) loss, some surrounded by areas of hypertrophy or hypopigmentation of the RPE. Partial loss of the choriocapillaris and neurosensory retina were also noted in areas of diseas RPE. Transmission electron microscopy showed numerous membranous lamellar inclusions and cytoplasmic bodies in the RPE cells. These data sh that didanosine primarily affects the RPE and that the choriocapillaris and overlying neurosensory retina are also dystrophic in areas of RPE loss. We also continue to follow a group of 75 adults treated with ddI with periodic fundus examinations and electrooculograms. One adult previously developed retinal lesions while treated with ddI, but no additional adult patients ha developed retinal lesions.