CYTOMEGALOVIRUS RETINITIS ASSOCIATED WITH OCCLUSIVE VASCULOPATHY IN AN ELDERLY, HUMAN IMMUNODEFICIENCY VIRUS-NEGATIVE MAN.
CYTOMEGALOVIRUS RETINITIS ASSOCIATED WITH OCCLUSIVE VASCULOPATHY IN AN ELDERLY, HUMAN IMMUNODEFICIENCY VIRUS-NEGATIVE MAN.
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巨细胞病毒性视网膜炎与人类免疫缺陷病毒阴性老年人的闭塞性血管病相关。
DOI：
10.1097/icb.0000000000000639
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发表时间：
2018
影响因子：
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通讯作者：
CunninghamJr,EmmettT
中科院分区：
文献类型：
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作者：
Moussa,Kareem;Doan,Thuy;Stewart,JayM;Shantha,Jessica;Gonzales,John;Acharya,Nisha;CunninghamJr,EmmettT
目的：提出一个与阻塞性血管病变的巨细胞病毒（CMV）视网膜炎的情况下，作为突然单方面丧失视力的人类免疫缺陷病毒阴性的老年man.Methods：临床病例报告和文献复习。结果：一个84岁的中国男子糖尿病和原发性开角型青光眼被认为是在咨询我们的葡萄膜炎服务评价突然视力丧失的右眼。检查发现阻塞性视网膜血管病变。进行了广泛的诊断性检查，包括荧光素血管造影、梅毒和结核等感染性病因的血清学检测以及颞动脉活检。患者接受大剂量口服泼尼松治疗，之后活检显示巨细胞动脉炎阴性。初次就诊后三周，发现患者颞周有新的视网膜炎区域。进行前房穿刺术，并将液体送去进行定向聚合酶链反应检测，结果显示CMV阳性。人体免疫缺陷病毒检测呈阴性。他与口服缬更昔洛韦和玻璃体内膦甲酸注射液和感染随后resolved.Conclusion：巨细胞病毒感染可以与闭塞性血管病变在人类免疫缺陷病毒阴性的个人。CMV视网膜炎的诊断应考虑在人类免疫缺陷病毒阴性的患者谁有其他条件，可能会损害免疫功能，特别是高龄，糖尿病，恶性肿瘤，或使用免疫抑制剂。
Purpose:To present a case of cytomegalovirus (CMV) retinitis associated with occlusive vasculopathy presenting as sudden unilateral loss of vision in a human immunodeficiency virus–negative elderly man.Methods:Clinical case report and literature review.Results:An 84-year-old Chinese man with diabetes mellitus and primary open-angle glaucoma was seen in consultation by our uveitis service for evaluation of sudden vision loss in the right eye. Examination revealed an occlusive retinal vasculopathy. An extensive diagnostic workup was performed, including fluorescein angiography, serologic testing for infectious etiologies including syphilis and tuberculosis and a temporal artery biopsy. The patient was treated with high-dose oral prednisone, after which the biopsy returned negative for giant-cell arteritis. Three weeks after initial presentation, the patient was noted to have a new area of retinitis in the temporal periphery. An anterior chamber paracentesis was performed, and the fluid was sent for directed polymerase chain reaction testing, which returned positive for CMV. Human immunodeficiency virus testing was negative. He was treated with oral valganciclovir and intravitreal foscarnet injections and the infection subsequently resolved.Conclusion:Cytomegalovirus infection can be associated with occlusive vasculopathy in human immunodeficiency virus–negative individuals. The diagnosis of CMV retinitis should be considered in patients with human immunodeficiency virus–negative who have other conditions that may compromise immune function, particularly advanced age, diabetes mellitus, malignancy, or use of immunosuppressive agents.