方法：回顾性分析我院感染科2010-01/2015-12收治确诊为AIDS合并CMVR患者60例103眼，对其临床表现、眼底病变、CD4⁺T淋巴细胞计数及预后等进行观察。

结果：初诊视力≤0.1者65眼(63.1%)，>0.1～<0.3者26眼(25.2%)，≥0.3者12眼(11.7%)，眼底改变表现为沿血管分布的黄白色病灶，伴片状出血，较少累及玻璃体。患者60例103眼，其中37眼(35.9%)视网膜病变主要累及后极部，45眼(43.7%)主要累及周边部，21眼(20.4%)为混合型。60例患者中CD4⁺T淋巴细胞计数平均38.6±12.3个/μL，其中≤50个/μL 43例(71.7%)，>50～<100个/μL 8例(13.3%)，≥100个/μL 9例(15.0%)。经高效抗逆转录病毒治疗(HARRT)及抗巨细胞病毒(CMV)治疗后，66眼视力提高，19眼视力不变，18眼视力下降。54例患者CD4⁺T淋巴细胞计数升高，治疗前后CD4⁺T细胞变化有统计学差异(P<0.05)。5例9眼为HARRT后IRIS的CMVR，经抗病毒治疗，病情得到控制。

结论：CMVR为AIDS常见眼部并发症，当CD4⁺T淋巴细胞计数≤50个/μL时应常规进行眼科检查。IRIS的CMVR预后较差。

METHODS: Patients who accepted treatments diagnosed with AIDS in our hospital of Department of Infectious Disease from Jan. 2010 to Dec. 2015 were retrospective analyzed. Sixty cases(103 eyes)with cytomegalovirus retinitis were identified. The clinical symptoms, the fundus manifestation, CD4⁺T cell count and the prognosis were examined.

RESULTS: Visual acuity of 65 eyes(63.1%), 26 eyes(25.2%), and 12 eyes(11.7%)were ≤0.1, 0.1-0.3 and ≥0.3 respectively. The fundus manifestations had yellow-white lesions along vascular distribution and hemorrhage of retina. The vitreous body was rarely involved. The retinal necroses in 37 eyes(35.9%)involved the posterior pole, 45 eyes(43.7%)involved peripheral region, and 21 eyes(20.4%)with mixed type. In 60 patients, CD4⁺T cells counts was 38.6±12.3 cells/μL on average, 43 cases(71.7%)of CD4⁺T cells is ≤50 cells/μL, 8 cases(13.3%)of CD4⁺T cells >50-100 cells/μL, and 9 cases(15.0%)>100 cells/μL. Visual acuity of 89 eyes improved with highly active antiretroviral therapy(HARRT)and anti-CMV treatment, 19 eyes unchanged, 18 eyes decreased, and CD4⁺T cells counts was significantly higher(P<0.05). Five patients(9 eyes)with IRIS were responded well to treatment.

CONCLUSION: CMVR is a common intraocular complication of AIDS. Routine fundus examination should be performed when the CD4⁺T cells counts is less than ≤50 cells/μL. Immune reconstitution inflammatory syndrome CMV retinopathy has worse in the prognosis.