高剂量内甘西克洛维尔的推定黄斑毒性
Shubhra Sweta1, Parvathy Prabhakaran1, Chaithra Kakunje1
1Department of Vitreo-Retina, Sankara Eye Hospital, Shimoga, Karnataka, India.
Taiwan journal of ophthalmology
|January 12, 2026
概括
较高剂量的内甘西克洛维尔可能会导致细胞巨乳病毒视网膜炎患者的黄斑毒性. 停止高剂量治疗导致视力改善和视网膜变化的解决,这表明在增加甘西克洛维尔度时要谨慎.
科学领域:
- 眼科医生 眼科 眼科
- 病毒学 病毒学
- 毒理学 毒理学 毒理学
背景情况:
- 细胞巨病毒 (CMV) 视网膜炎是免疫功能低下个体的严重眼部并发症.
- 静脉内甘西克洛维尔是一种标准治疗方法,但最佳剂量和潜在的毒性需要进一步研究.
- 在CMV视网膜炎中,斑点的参与可以显著影响视力敏度.
研究的目的:
- 在患有CMV视网膜炎的患者中报告一种高剂量内甘西克洛维尔的二次性斑毒性病例.
- 为了评估不断升高的静脉内甘西克洛维尔剂量的安全性和有效性.
- 突出监测药物诱导毒性的重要性.
主要方法:
- 一名56岁的男性患有双边CMV视网膜炎,接受了口服瓦尔甘西克洛维尔和不断升级的静脉内甘西克洛维尔剂量 (2毫克,4毫克,然后6毫克) 的治疗.
- 眼部检查包括 funduscopy 和光学连贯性断层扫描 (OCT),以评估治疗反应和毒性.
- 根据临床反应和OCT发现,进行了治疗调整.
主要成果:
- 初始治疗2毫克的静脉内甘西克洛维尔显示出低于最佳的反应,促使剂量升级.
- 在接受了4毫克,随后6毫克静脉内甘西克洛维尔治疗后,患者在OCT上经历了视力恶化和神经感官脱落 (NSD) 和内视网膜超反射性.
- 停止高剂量静脉内甘西克洛维尔治疗并继续口服瓦尔甘西克洛维尔治疗,导致视力改善,并在一个月内消除了海上国家和地区的发现.
结论:
- 高剂量内甘西克洛维尔 (4毫克和6毫克) 可能与黄斑毒性有关,呈现为NSD和视网膜超反射性.
- 虽然以前已经使用了更高的剂量,但这种情况表明要谨慎,避免剂量超过2 - 4毫克/0.08毫升,以防止眼部毒性.
- 仔细监测和个性化剂量对管理CMV视网膜炎至关重要,以平衡疗效和安全性.
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