Analysis of Clinical Characteristics of Patients with Recurrent Cytomegalovirus Retinitis after Hematopoietic Stem Cell Transplantation.
Analysis of Clinical Characteristics of Patients with Recurrent Cytomegalovirus Retinitis after Hematopoietic Stem Cell Transplantation.
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DOI：
10.3390/jpm13040639
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发表时间：
2023-04-07
影响因子：
--
通讯作者：
Wang, Changguan
中科院分区：
文献类型：
--
作者：
Wang, Xiaona;Lu, Yao;Li, Haiping;Ma, Zhizhong;Hong, Jing;Wang, Changguan
关键词：
目的：分析总结造血干细胞移植（HSCT）后巨细胞病毒性视网膜炎（CMVR）复发患者的临床及影像学特征。方法：这项回顾性病例系列研究招募了 HSCT 后出现 CMVR 的患者。该研究将治疗后病灶稳定且房水中 CMV 阴性的患者与治疗后病灶复发且房水中 CMV DNA 载量再次增加的患者进行了比较。观察指标为患者的基本临床资料、最佳矫正视力、广角眼底照相、光学相干断层扫描（OCT）、血CD4+T淋巴细胞计数、房水CMV载量。我们对数据进行汇总并统计分析复发组和非复发组之间的差异以及观察指标的相关性。结果：该研究招募了 52 名 HSCT 后出现 CMVR 的患者（82 只眼），其中 11 名患者（15 只眼）治疗后复发（21.2%）。复发间隔为6.4±4.9个月。复发患者最终最佳矫正视力为0.3±0.3。复发患者发病时CD4+T淋巴细胞数量为126.7±80.2/mm3。复发时房水中检测到的 CMV DNA 载量中位数为 8.63 × 103 拷贝/mL。复发组和非复发组发病时CD4+T淋巴细胞计数存在显着差异。复发患者的起始视力与最终视力和复发病灶面积显着相关。复发 CMVR 的眼底显示原始稳定病变的边缘活动增加。同时，稳定、萎缩、坏死病灶周围出现黄白色新病灶。 OCT 显示旧病灶附近的视网膜神经上皮层出现新的弥漫性反射亢进病灶。玻璃体内观察到炎症性点状反射亢进，伴有玻璃体液化和收缩。结论：本研究提示HSCT后CMVR复发的临床特征、眼底表现和影像学特征与初次发病时不同。患者病情稳定后应密切随访，警惕CMVR复发。
Objective: To analyze and summarize the clinical and imaging characteristics of patients with cytomegalovirus retinitis (CMVR) relapse after hematopoietic stem cell transplantation (HSCT). Methods: This retrospective case series study recruited patients with CMVR after HSCT. The study compared the patients with stable lesions and CMV-negative aqueous humor after treatment with those with relapse lesions and a CMV DNA load in aqueous humor which had increased again after treatment. The observation indexes were basic clinical information, best-corrected visual acuity, wide-angle fundus photography, optical coherence tomography (OCT), blood CD4+ T lymphocyte count, and aqueous humor CMV load of the patients. We summarized the data and statistically analyzed the differences between the relapse and non-relapse groups, as well as the correlations of the observed indicators. Results: The study recruited 52 patients with CMVR (82 eyes) after HSCT, of whom 11 patients (15 eyes) had recurrence after treatment (21.2%). The recurrence interval was 6.4 ± 4.9 months. The final best-corrected visual acuity of recurrent patients was 0.3 ± 0.3. The number of CD4+ T lymphocytes in recurrence patients at the time of onset was 126.7 ± 80.2/mm3. The median CMV DNA load detected in aqueous humor at the time of recurrence was 8.63 × 103 copies/mL. There was a significant difference in the CD4+ T lymphocyte count between the recurrence and the non-recurrence groups at onset. The onset of visual acuity in recurrence patients was significantly correlated with final visual acuity and recurrence lesion area. The fundus of recurred CMVR showed increased marginal activity of the original stable lesion. Concurrently, yellow-white new lesions appeared around the stable, atrophic, and necrotic lesions. OCT showed new diffuse hyperreflexic lesions in the retinal neuroepithelial layer near the old lesions. Inflammatory punctate hyperreflexes were observed in the vitreous, with vitreous liquefaction and contraction. Conclusion: This study suggests that the clinical features, fundus manifestations, and imaging features of CMVR recurrence after HSCT are different from those at the initial onset. Patients should be closely followed up after their condition is stable to be alert for CMVR recurrence.
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DOI：
10.3390/v15010185
发表时间：
2023-01-09
期刊：
Viruses
影响因子：
--
作者：
Zhang J;Kamoi K;Zong Y;Yang M;Ohno-Matsui K
通讯作者：
Ohno-Matsui K
影响因子：
1.4
作者：
Fan, Jing-Jing;Tao, Yong;Hwang, De-Kuang
通讯作者：
Hwang, De-Kuang
DOI：
10.3760/cma.j.cn112142-20220218-00062
发表时间：
2022-12-11
期刊：
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology
影响因子：
--
作者：
Lu, Y;Hong, J;Wang, C G
通讯作者：
Wang, C G
影响因子：
4.2
作者：
Pellegrini, Marco;Bernabei, Federico;Bonifazi, Francesca
通讯作者：
Bonifazi, Francesca
影响因子：
3.4
作者：
Vassallo F;Nuzzi R;Cattani I;Dellacasa C;Giaccone L;De Rosa FG;Cavallo R;Iovino G;Brunello L;Bruno B;Busca A
通讯作者：
Busca A