[Relationship between opacity of cytomegalovirus retinitis lesion borders and aqueous viral load among patients after allogeneic hematopoietic stem cell transplantation].
[Relationship between opacity of cytomegalovirus retinitis lesion borders and aqueous viral load among patients after allogeneic hematopoietic stem cell transplantation].
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DOI：
10.3760/cma.j.cn112142-20220218-00062
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发表时间：
2022-12-11
期刊：
影响因子：
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通讯作者：
Wang, C G
中科院分区：
文献类型：
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作者：
Lu, Y;Hong, J;Wang, C G
目的：探讨异基因造血干细胞移植后巨细胞病毒(CMV)视网膜炎的病变特征，包括病变大小和边缘混浊程度与CMV-DNA载量的关系。方法：采用回顾性病例系列研究方法。对北京大学第三医院眼科2018年1月至2020年10月间异基因造血干细胞移植后确诊为巨细胞病毒视网膜炎的患者资料进行回顾分析。用超广域眼底像检测病变大小，并用图像处理与分析软件ImageJ测量。通过蒙面阅读器评估病变边缘的不透明度。根据病变边缘的混浊程度，将CMV视网膜病变分为3种类型：可疑活动性病变、轻至中度混浊病变和重度混浊病变。所有患者均诊断为活动性巨细胞病毒性视网膜炎。在首次就诊和抗病毒药物诱导期结束时检测房水中的CMV-DNA。提取100毫升房水后，用聚合酶链式反应定量检测CMV-DNA载量，换算成常用的对数表示法。采用Pearson相关分析进行病变面积、病变边缘混浊程度与房水CMV-DNA载量的相关性分析。结果：46例71只眼，男26只眼，女20只眼。患者年龄27(13，33)岁。CMV视网膜炎活动性病变大小为40(12，65)个视盘区。疑似活动性病变8眼(11.3%)，边缘轻度至中度混浊51眼(71.8%)，边缘重度混浊12眼(16.9%)。初诊时67只眼(94.4%)为CMVDNA阳性，病毒载量为2.04×10~4(6.24×10~2，1.48×10~5)拷贝/ml，诱导治疗2周后，CMVDNA载量为2.47×10~2(1.08×10~3，6.87×10~3)拷贝/ml，相关分析显示，无论是发病时还是治疗后2周，房水中巨细胞病毒载量与病变边缘不透明程度均呈显著正相关(r=0.765，P
Objective: To evaluate the relationship between lesion features of cytomegalovirus (CMV) retinitis, including lesion size and degree of opacity of lesion borders, and aqueous CMV-DNA load in patients after allogeneic hematopoietic stem cell transplantation. Methods: It was a retrospective case series study. Data of patients diagnosed as CMV retinitis after allogeneic hematopoietic stem cell transplantation at the Department of Ophthalmology, Peking University Third Hospital from January 2018 to October 2020 were reviewed. Lesion size was detected by ultra-wide-field fundus image and measured by ImageJ, an image processing and analysis software. Opacity of lesion borders was evaluated by a masked reader. The CMV retinitis lesions were divided into 3 types according to the opacity degree of the border of the lesions: suspected active lesion mildly to moderately opacified lesion and severely opacified lesion. All eyes were diagnosed as active cytomegalovirus retinitis. CMV-DNA in aqueous humor was detected at the first visit and at the end of the induction period of antiviral drugs. CMV-DNA load was quantitatively detected by polymerase chain reaction after 100 mul of aqueous humor was extracted, and were converted to common logarithmic representations. Pearson correlation analysis was used to analyze the correlation between lesion area, opacity degree of lesion border and aqueous humor CMV-DNA load. Results: A total of 71 eyes from 46 patients were included and 26 was male and 20 was female. The age of the patients was 27(13, 33)years. The active lesion size of CMV retinitis was 40(12, 65) disc areas. Eight eyes (11.3%) had a suspected active lesion, 51 eyes (71.8%) had a mildly to moderately opacified lesion border, and 12 eyes (16.9%) had a severely opacified border. At the first visit, 67 eyes (94.4%) were CMV-positive, and the CMV-DNA load was 2.04*104 (6.24* 102, 1.48 *105) copies/ml. After 2 weeks of induction therapy, the viral load was 2.47*102 (1.08* 10, 6.87 *103) copies/ml. The correlation analysis showed that the CMV-DNA load in aqueous humor was significantly correlated with the lesion border opacity both at presentation and 2 weeks after intravitreal antiviral treatment (r=0.765, P