眼科 ›› 2025, Vol. 34 ›› Issue (2): 81-87.doi: 10.13281/j.cnki.issn.1004-4469.2025.02.001

• 标准与规范探讨 •    下一篇

HIV感染者巨细胞病毒性视网膜炎筛查和诊疗规范(2025年)

中国罕见病联盟/北京罕见病诊疗与保障学会眼科罕见病分会   

  • 收稿日期:2025-02-19 出版日期:2025-03-25 发布日期:2025-03-13
  • 通讯作者: 魏文斌,首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室 眼内肿瘤诊治研究北京市重点实验室 医学人工智能研究与验证工信部重点实验室 致盲性眼病防控及智能诊疗北京市重点实验室,北京 100730,Email:weiwenbintr@163.com
  • 基金资助:
    国家自然科学基金(82220108017,82141128);首都卫生发展科研专项(首发2024-1-2052);北京市科委科技计划项目(Z201100005520045);深圳市“医疗卫生三名工程”项目(SZSM202311018)

Screening, diagnosis, and treatment guidelines for cytomegalovirus retinitis in HIV-infected patients (2025)

Ophthalmology Group of China Alliance for Rare Diseases/Beijing Society of Rare Disease Clinical Care and Accessibility    

  • Received:2025-02-19 Online:2025-03-25 Published:2025-03-13
  • Contact: Wei Wenbin, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory Ophthalmology and Visual Science, Beijing Key Laboratory of Diagnosis and Treatment of Intraocular Tumors, Key Laboratory of Medical Artificial Intelligence Research and Verification, Ministry of Industry and Information Technology, Beijing Key Laboratory of Blind Eye Disease Prevention and Intelligent Diagnosis and Treatment, Beijing 100730, China, Email: weiwenbintr@163.com
  • Supported by:
    National Natural Science Foundation of China (82220108017, 82141128); The Capital Health Research and Development of Special (2024-1-2052); Science & Technology Project of Beijing Municipal Science & Technology Commission (Z201100005520045); Sanming Project of Medicine in Shenzhen (SZSM202311018)

摘要: 人类免疫缺陷病毒(HIV)感染者因免疫功能被抑制易发机会性感染,其中巨细胞病毒性视网膜炎(CMVR)是最具致盲性的眼底疾病,未及时干预可导致不可逆视力损害。我国基层医疗资源分布不均,HIV感染者眼底病筛查率不足,且现有诊疗体系缺乏针对CMVR的标准化流程。本规范以CMVR为核心研究对象,基于多中心循证证据,构建“筛查-诊断-治疗-随访”全流程管理体系。通过整合检眼镜、超广角眼底照相等技术优化筛查路径,明确诱导期与维持期抗病毒治疗策略,并建立CD4+T淋巴细胞分层随访机制。本规范提出以传染病医院为主体、多学科协作的CMVR管理模式,推进HIV相关眼病的规范化诊疗,旨在降低致盲率,提升患者视觉相关生活质量,为全球HIV眼病防控提供中国实践参考。 (眼科,2025,34: 81-87)

关键词: 人类免疫缺陷病毒, 巨细胞病毒性视网膜炎, 诊疗指南

Abstract:  Human immunodeficiency virus (HIV)-infected individuals are prone to opportunistic infections due to immunosuppression, with cytomegalovirus retinitis (CMVR) being the most vision-threatening retinal disease. Untreated CMVR can lead to irreversible vision loss. In China, uneven distribution of primary healthcare resources and insufficient retinal screening rates among HIV-infected populations, coupled with the lack of standardized protocols for CMVR management, hinder timely intervention. This guideline focuses on CMVR as the core subject, establishing a comprehensive "screening-diagnosis-treatment-follow-up" framework based on multicenter evidence. It optimizes screening pathways by integrating ophthalmoscopy and ultra-widefield fundus photography, clarifies antiviral strategies for induction and maintenance phases, and proposes a CD4+T lymphocyte-stratified follow-up mechanism. For the first time, this guideline advocates a multidisciplinary collaboration model led by infectious disease hospitals to standardize CMVR management. It aims to reduce blindness rates, improve vision-related quality of life, and provide Chinese practice references for global HIV-related ocular disease prevention and control. (Ophthalmol CHN, 2025, 34: 81-87)

Key words:  human immunodeficiency virus, cytomegalovirus retinitis, diagnosis and treatment guidelines