Icandelo elingasemva lemisebenzi yamehlo ngokugcina umlo we-eyeball, ukubamba i-lens endaweni, nokudala iimpembelelo zesibindi kwiqondo le-cellreceptor cells emva kwamehlo.
I- retina , i- choroid (i-laycular layer of eye), kunye ne-optic nervous iquka inxalenye enkulu yecandelo eliphambili, kunye neengxaki ezinxulumene ne-HIV ezibonakalisa ngaphakathi kwezi zixhobo zecala, ngokuphindaphindiweyo kwisifo se-HIV kwisithuba esilandelayo.
Iintlupheko zecandelo le-posterior-ngokuyinxalenye ebonisa ngeenguqu zethambo kwi-retina-zibonakala kubangama-50% ukuya kwi-70% yezigulane ezine- HIV , kwaye mhlawumbi kunokubangela ukulimala okuqhubekayo okanye okunamandla kwi-retina (ebizwa ngokuba yi-retinopathy).
Ezinye izifo ezinxulumene ne-HIV zecandelo elingaphambili liquka:
- I-Cytomegalovirus (eyaziwa nangokuthi yi-CMV)
- I-Toxoplasmosis (intsholongwane eqhelekileyo neyosuleleka ngokutheleleka)
- I-Cryptococcosis (enye isifo sofuba esifana nesifo sengculaza)
- Isifo sofuba (TB)
Cytomegalovirus
I-Cytomegalovirus (i-CMV) yi-herpesvirus echaphazela ngaphezu kwesigamu sabemi abadala, engabonakaliyo ngesifo kulabo abanamasosha omzimba afanelekileyo (ngaphandle kwezinye iimeko, kunye neempawu ezinjenge- mononucleosis ). Nangona kudla ngokugqithiswa ngokusuka kumama ukuya kumntwana, kunokusasazwa ngokudala ngomntu oqhagamshelana naye ngokwesondo. Ngaloo ndlela, ukuxhaphazwa kwe-CMV phakathi kwamadoda abelana ngesondo kunye nabesilisa kuba malunga nama-90%, njengokuba kunabantu abane-HIV ephambili.
I-CMV ingabonisa ngamehlo ngeendlela eziliqela, nangona kunjalo ngokuqhelekileyo yenza njalo kunye nokuvuvukala komzimba we-retina, eyaziwa nje ngokuba yi-retinitis. Esi sifo sisoloko sifika kwizigulane ezingama- CD4 count ehlile ngaphantsi kweeseli ezingama-50 / mL kwaye zibonakalise iimpawu ezivela kwimbono yezinto ezihamba ngeenqwelo zokutshatyalaliswa kwintlungu ebonakalayo kunye nokuba yimfama.
Xa izilonda ze-CMV zichongiwe kwi-retina, ziyakwazi ukuhambela ngokukhawuleza, rhoqo kwiiveki. Ngaphandle kokungenelela kwezonyango, izilonda zingaphumelela kwi-centrifugally (ukwandisa ngaphandle ukusuka kwiziko), ukunciphisa ubunzima obubonakalayo kwaye ngamanye amaxesha kubangela ukulahlekelwa ngokupheleleyo kombono. Nangona i-CMV retinitis ihlala iveza ngokubanzi (kwimiba mibini), inokuthi ibonise unilaterally (kwelinye iso).
I-Valganciclovir ithathwa njengeziyobisi ezikhethiweyo zonyango lwe-CMV retinitis, ngomlomo ochazwe ngomlomo njenge-dose yemihla ngemihla ngethuba lokunyulwa, elilandelwa ngumthamo wemihla ngemihla kwisondlo. I-Ganciclovir inokumiselwa kodwa ihanjiswe kwangaphakathi, kunokuba isetyenziswe ngomlomo, ixesha elingangeentsuku ezili-21.
Ngenye indlela, i-intravitreal ganciclovir implants-ngokoqobo, iincinci ezincinci ezingenakunikwa ngqo kwindawo yesifo-ngamanye amaxesha zifakwe kwiso. Izihlandlo ezisetyenziswayo kwiimeko ezinzulu ze-CMV retinitis, ivumela ukuhlala ixesha elide, elondoloziweyo lwezilwanyana kwi-vitreous humor (i-gel ecacileyo egcwalisa isikhala phakathi kwe-lens kunye ne-retina).
Toxoplasma
I-Toxoplasma iyona nto ibangela i-retinochoroiditis (intsholongwane ye-retina kunye / okanye i-choroid) kubemi jikelele, kwaye yesibini ibonakala kakhulu kubantu abane-HIV.
Ekubangelwa i-protozoan parasite, i- Toxoplasma gondii , eso sifo sichaphazela abantu abangaphezu kwama-200 000 e-US ngonyaka, kwaye sisasazeka ngokungaphili okanye ngokungeniswa kwenyama ecocekileyo. Eyona nto ibininzi idibene neekati (nangona ikhona kwizidalwa ezininzi ezifudumalayo), ukunxibelelana neentambo zentaka kubonakala nokuba yimbangela ebalulekileyo yokudluliselwa kwe- T. gondii .
Xa i-toxoplasmosis ibeka iliso, ibonakalisa i-yellow-white to grey light-grey ehamba kunye nokuvuvukala kwe-vitreous humor. Ukuchonga kunokwenziwa rhoqo ngokuhlolwa kwamehlo, kunye nokuhlolwa kwegazi okuchasene nomntu okwenzela ukuqinisekiswa kwe-serological.
Ngamanye amaxesha ama-steroids asetshenziselwa ukuphatha iimeko ezinzima ze-toxoplasma retinochoroiditis, ngelixa iimeko ezinzima zihlala zichongwa ngokuhlanganiswa kwe-pyrimethamine, i-folinic acid kunye ne-sulfadiazine. Kubantu abanesifo esiphezulu se-HIV, kunokuqhubeka unyango olungapheliyo, ngokuphindaphindiweyo kunye nokusetyenziswa kwe-trimethoprim-sulfamethoxazole, ukudibanisa okuqhelekileyo ukunyamezela.
Cryptococcosis
I-Cryptococcosis iyintsholongwane ebangelwa ukunyusa i-airborne, i- Cryptococcal neoformans spores, enokuthi ibonakale nge-meningitis (ngezinye izihlandlo ezisongela ubomi ezikhuselekileyo ezijikeleza ingqondo kunye nomgudu womgudu). Uninzi lwentsebenzo ye-ocular lukhula njengentetho yesibini ngexesha lobunzima be- cryptococcal meningitis , ngakumbi xa ihamba ne-septicemia.
Izifo ezise-OMS zingadluliselwa kwi-system central nervous system (CNS) nge-nertic optic okanye ngokusebenzisa igazi xa isifo sisasazwa (okt, sisasazeka ngaphaya kwe-HIV).
Xa kuhlolwa, izilonda ezininzi eziluhlaza zingabonwa kwi-choroid kunye / okanye kwi-retina. Ukuba ukushiywa kungakhange kulandelwe, ukusasazeka kwintsholongwane yeentsimbi ze-optic ngamanye amaxesha kungabangela ukulahleka okubonakalayo.
Ukunikwa kwendlela yokwenza i-cryptococcal meningitis ngokubanzi ihanjiswa nge-intraveous amphotericin B kunye ne-flucytosine, ithathwa njengonyango olukhethiweyo. Amachiza antifungal aphindaphindiweyo xa kubandakanywa ukubandakanyeka komntu.
Isifo sofuba
Isifo sofuba (i-TB) sininzi esingaqhelekanga kunezinye izifo zamehlo ezinxulumene ne-HIV kodwa ngamanye amaxesha kubonakala kwizigulane ze-HIV ezine-TB ezisebenzayo. Idla ukubonisa njenge-granuloma enjenge-gululoma kwi-choroid kwaye ingabonakalisa kumaxabiso angaphezulu kwe-CD4 (ngaphezu kwe-150 iiseli / mL) kunezinye izifo ezihambelana ne-HIV zecandelo elingasemva. Unyango oluchanekileyo kunye neziyobisi ezichasene ne-TB ngokuqhelekileyo zinqunywe njengekhambi lokunyusa.
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