Izvozvo zvinotevera chikamu cheziso chinoshanda nekuchengetedza chimiro cheziso reziso, kubatisisa lens panzvimbo, nekukonzera mafungiro emagetsi kuuropi kubva ku photoreceptor masero kumashure kwemaziso.
Iyo retina , chiroroid (iyo yakasara yakavhara yeziso), uye mutsara we optic unobatanidza chikamu chepamusoro pepashure, pamwe nehuwandu hwehutano hunobatanidza HIV huri mukati mematanda aya, kakawanda mumatambudziko anotevera HIV.
Kushungurudzika kwemashure ekupedzisira-kunyanya kuratidza nekuchinja kwemasimba kune retina-kunowanikwa mune dzakawanda kusvika 50% kusvika ku70% yevarwere vane HIV , uye pane imwe nguva inogona kuguma nekukuvadza kana kukuvadza kwakanyanya kune retina (inonzi retinopathy).
Zvimwe zvirwere zvinotapukirwa neHIV zvepashure chikamu zvinosanganisira:
- Cytomegalovirus (inozivikanwawo seCMV)
- Toxoplasmosis (chirwere chakajairika uye chinowanikwa nyore nyore)
- Cryptococcosis (imwe inowanzobatwa neHIV-inokonzerwa nehutachiona hwehutachiona)
- Tuberculosis (TB)
Cytomegalovirus
Cytomegalovirus (CMV) inonzi herpesvirus inokonzera hafu yevanhu vakuru, vasingatauri kuratidza nechirwere kune avo vane maitiro ezvidziviriro zvemasimba (kunze kwe, pane dzimwe nguva, ane zviratidzo zvinonzi mononucleosis -zvakadai). Kunyange zvazvo inowanzopfuura ichibva kune amai kuenda kumwana, inogonawo kutapudzwa muhukuru kuburikidza nekuita zvepabonde. Sezvo zvakadaro, kuwandisa kweVMV pakati pevarume vanoita zvepabonde nevarume inenge 90%, sezvinongoita nevanhu vane hutachiwana hweHIV.
CMV inogona kuisa mumaziso munzira dzakawanda, kunyange zvazvo inowanzoita kudaro neimwe nguva inoputika kuputika kwe retina, inozivikanwa sekuti retinitis. Chirwere ichi kazhinji chinowanikwa kune varwere vane CD4 count yakaderera pasi pemakumi mashanu emamiriyoni / mL uye inoratidza zviratidzo kubva kubva pakufunga kwezvinhu zvakasvibirira kusvika pakuona kurasikirwa uye kunyange kupofu.
Kana kamwe masikirwo emu CMV akawanikwa pane retina, anogona kukurumidza kufambira mberi, kazhinji mukati memavhiki. Pasina kupindira mune zvokurapa, zvipembenene zvinogona kufambira mberi centrifugally (kuwedzera kunze kubva mukati), kuderedza kuonekwa kwakanaka uye dzimwe nguva kutungamirira mukurasika kwakakwana kwemaonero. Kunyange zvazvo CMV retinitis inowanzotaura zviri zviviri (mumaziso ose), inogonawo kupa unilaterally (mune rimwe ziso).
Valganciclovir inonzi inodhaka yemishonga yekusarudzwa kwe CMV retinitis, yakatemwa nemuromo semurosi-zuva rimwe nerimwe panguva yekubvongodza, inoteverwa neipi imwechete-zuva rimwe nerimwe rekugadzirisa nguva. Ganciclovir inogonawo kunyorwa asi inoponeswa mukati, panzvimbo pemuromo, kwemazuva anenge makumi maviri nemaviri.
Zvimwe, intravitreal ganciclovir implants-literally, miniti injectable rod inowanikwa zvakananga panzvimbo yehutachiona-dzimwe nguva inopindirwa muziso. Kazhinji inoshandiswa mune zviitiko zvakanyanya zve CMV retinitis, inobvumira nguva yakareba, yakachengetedzwa mishonga mu vitreous humor (gel yakajeka inozadza nzvimbo pakati pe lens ne retina).
Toxoplasma
Toxoplasma ndicho chikonzero chinowanzoita chetinochoroiditis (utachiona hwetina uye / kana chirosi) muhuwandu hwevanhu, uye yechipiri inowanikwa kune vanhu vane HIV.
Inokonzerwa nehutachiona hweprotozoan, Toxoplasma gondii , chirwere chacho chinokanganisa vanhu vanopfuura 200 000 muUnited States gore negore, uye rinopararira kana kuti rinopararira kana kupinza nyama yakasvibiswa. Kazhinji kazhinji inobatanidzwa nemakati (kunyange zvazvo aripo mune zvisikwa zvakawanda zvinotonhora), kusangana nemakumbo emakungwa kunoonekwawo sechikonzero chinokonzera kutapurirana kweT. gondii .
Apo toxoplasmosis inowanikwa muziso, inoratidzika nemuchena-machena kusvika kuchena-greysi yegoni pamwe chete nekuputika kwe vitreous humor. Chizivo chinowanzoitwa neziso rekuongorora, nevanopesana ne- anti- based blood test iyo inopa kuvimbiswa kwechipiri.
Dzimwe nhepfenyuro dzinonzi steroid dzimwe nguva dzinoshandiswa kuronga mamiriro ezvinhu akaoma e-toxoplasma retinochoroiditis, asi mamwe maitiro akaoma anowanzotarisirwa kusanganiswa kwe pyrimethamine, folinic acid uye sulfadiazine. Kune vanhu vane hutachiona hweHIV, kuenderera mberi kwechirwere chisingaperi kunogona kudiwa, kazhinji nekushandisa trimethoprim-sulfamethoxazole, kusanganiswa kwaro kunowirirwa zvakanaka.
Cryptococcosis
Cryptococcosis chirwere chinokonzerwa nekuputika kwemhepo, Cryptococcal neoformans spores, iyo inogona kuratidzira neine meningitis (dzimwe nguva kupisa kwehupenyu kunopisa kwemakumbo ekudzivirira anopoteredza uropi nemumutsipa wesipinha). Zvose zvinowanzobatanidzwa zvinowanzoita sechipiri chekupa hurukuro panguva dzakaoma zvinyorwa zve cryptococcal meningitis , kunyanya kana inosangana ne septicemia.
Zvirwere zveEcular zvinogona kuendeswa kuburikidza ne-central central nerve system (CNS) kuburikidza neropa re optic kana kuburikidza neropa apo chirwere chacho chinoparadzirwa (kureva, kupararira kupfuura chetachiona chetachiona).
Pamusoro pekuongororwa, mishonga yakawanda yemajena inogona kuonekwa pane choroid uye / kana retina. Kana ikasatenderwa, kupararira kwehutachiona kumatumbu ehutano hwemagetsi dzimwe nguva kunoguma nekurasikirwa kwezvinhu.
Kugadziriswa kwekristptococcal meningitis kunowanzobudiswa nenzira yepravenous amphotericin B uye flucytosine, inofungidzirwa kurapwa kwesarudzo. Mishonga yeAntifungal inowanzorongedzerwa kana kusanganisa kunenge kuchifungidzirwa.
Tuberculosis
Tuberculosis (TB) inowanzove isina kudarika kune dzimwe zvirwere zvemaziso zvinokonzerwa neHIV asi dzimwe nguva zvinowanikwa muHIV vane varwere vane hutachiona hweHIV. Iyo inowanzoita seyenduru-yakaita segranuloma pane choroid uye inogona kuratidza pamatunhu akakwirira eCD4 (makuru kupfuura 150 masero / mL) kupfuura dzimwe zvirwere zvinotarisana neHIV zvechikamu chemashure. Kurapa kwakarongeka nemishonga inopesana neTB inowanzorongedzerwa sezvinorayirwa nzira yekuita.
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