Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
Ocular Oncology and Autoimmune Center, The Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Tel Aviv-Yafo, Israel.
Acta Ophthalmol. 2018 Nov;96(7):e761-e767. doi: 10.1111/aos.13553. Epub 2017 Oct 25.
In recent years, numerous reports have tied cytomegalovirus retinitis (CMVR) with multiple systemic conditions in the absence of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). These range from reports in apparently healthy individuals, through conditions rendering limited immune dysfunction such as advanced age and diabetes mellitus, and finally severe immune dysfunction such as in haematological and rheumatological conditions. Reports are also emerging, suggesting that induced local ocular immunosuppression is a risk factor for CMVR. We herein present a comprehensive collection of the accumulated findings regarding CMVR in non-HIV patients. We summarize the spectrum of underlying morbidity that has been associated with CMVR, its clinical presentation, diagnostic methods and treatment choice in the attempt to suggest the optimal treatment strategy in this complicated and diverse patient population which is still currently lacking a consensus.
近年来,大量报告将巨细胞病毒视网膜炎(CMVR)与多种非人类免疫缺陷病毒(HIV)或获得性免疫缺陷综合征(AIDS)相关的全身状况联系起来。这些报告范围从看似健康的个体,到导致有限免疫功能障碍的情况,如高龄和糖尿病,最后是严重的免疫功能障碍,如血液学和风湿病。报告还表明,诱导局部眼部免疫抑制是 CMVR 的一个危险因素。我们在此综合收集了非 HIV 患者中 CMVR 的累积发现。我们总结了与 CMVR 相关的潜在发病率谱,及其临床表现、诊断方法和治疗选择,试图为目前仍缺乏共识的这一复杂和多样化的患者群体提出最佳治疗策略。