OCULAR MANIFESTATIONS OF THE ACQUIRED IMMUNE DEFICIENCY SYNDROME

艾滋病患者有可能出现严重的 由于人类免疫缺陷导致的眼部问题 病毒（HIV）本身或机会性感染的结果。 一些 这些问题如果不及时治疗会导致失明。 中 许多病原体可导致失明，巨细胞病毒（CMV）是 最常见的 在1992财政年度， 研究这种疾病。 一些CMV视网膜炎研究集中在 关于预防。 早期开始治疗对于 保存有用的视力。 然而，所有可用的药物都是 抑制病毒的，而不是杀病毒的;患者需要服用药物， 如果他们想保住视力， 如果有人能阻止 CMV视网膜炎的发展，这将被认为是一个重大进展。 在这方面，我们参加了免疫的第一阶段试验， 在有发生CMV视网膜炎风险的患者中使用球蛋白。 其他CMV视网膜炎研究集中在治疗上。 我们继续 评价膦甲酸钠和更昔洛韦预防 CMV视网膜炎的进展。 评估的两个具体问题是 (1)在治疗终末期患者的可能选择 视网膜手术后眼内有硅油的CMV视网膜炎 分离和（2）使用药物输送系统的可能性 对于眼睛来说，这将减少系统治疗的需要。 在1992财政年度的儿科艾滋病研究中，我们继续评估 眼部感染的发病率约为220例艾滋病患儿。 儿童的并发症发生率低于成人。 然而，儿童CMV视网膜炎更难治疗。 接受2'，3'-双脱氧肌苷治疗的儿科患者亚群 (ddI)，提示药物毒性的周边视网膜变化已被 观察和报告，因为我们继续监测这些儿童。 1992财政年度关于艾滋病的其他研究包括评价一种新的抗病毒药物 一种治疗艾滋病患者眼部弓形虫病的药物。

Patients suffering from AIDS are at risk of developing significant ocular problems either as a result of the human immunodeficiency virus (HIV) itself or as a result of opportunistic infections. Some of these problems can lead to blindness if left untreated. Among the many pathogens that can lead to blindness, cytomegalovirus (CMV) is by far the most common. In FY 1992 several approaches have been taken to investigate this disease. Some CMV retinitis studies focused on prevention. Early initiation of therapy is important for the preservation of useful vision. However, all the drugs available are virostatic, not virocidal; patients are required to take medication for life if they want to preserve their sight. If one could prevent the development of CMV retinitis, it would be considered a major advance. In this regard, we have participated in a phase I trial of immune globulin in patients at risk for development of CMV retinitis. Other CMV retinitis studies focused on therapy. We have continued to evaluate the ability of foscarnet and ganciclovir to prevent progression of CMV retinitis. Two particular questions evaluated were (1) the possible options in the treatment of patients with end-stage CMV retinitis who have silicone oil in their eyes following retinal detachment and (2) the possibility of using a drug delivery system for the eye, which would obviate the need for systemic therapy. In studies of pediatric AIDS during FY 1992, we continued to evaluate the incidence of ocular infection in about 220 children with AIDS. The incidence of complications is lower in children than in adults. However, CMV retinitis in children is more difficult to treat. In a subpopulation of pediatric patients treated with 2',3'-dideoxyinosine (ddI), peripheral retinal changes suggesting drug toxicity have been observed and reported as our monitoring of these children continues. Other FY 1992 studies on AIDS include evaluation of a new antiviral drug for the treatment of toxoplasmosis in AIDS patients' eyes.