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IL-8 引导的水溶液治疗在骨髓造血干细胞移植后巨细胞病毒视网膜炎中的疗效和安全性。

Efficacy and Safety of Aqueous Interleukin-8-Guided Treatment in Cytomegalovirus Retinitis after Bone Marrow Hematopoietic Stem Cell Transplantation.

机构信息

Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroidal Diseases, College of Optometry, Peking University Health Science Center, Beijing, China.

Harvard Eye Associates, Private Practice, Laguna Hills, CA, USA.

出版信息

Ocul Immunol Inflamm. 2022 Apr 3;30(3):758-765. doi: 10.1080/09273948.2020.1823422. Epub 2020 Oct 16.

Abstract

PURPOSE

To explore the optimal treatment for cytomegalovirus retinitis (CMVR) in patients status-post Allogeneic bone marrow hematopoietic stem cell transplantation (Allo-HSCT), based on aqueous humor indicators.

METHODS

A randomized controlled study with 35 eyes. Eyes were randomized with a 1:1 ratio to standard treatment group (Group 1, with treatment endpoint as aqueous CMV-DNA load<10 copy/ml), and interleukin (IL)-8 group (Group 2, with treatment endpoint as aqueous IL-8 level <30 pg/ml or CMV-DNA load<10 copy/ml) to receive antiviral intravitreal injections. Number of injections, CMVR recurrence rate, complication rate, and vision changes were analyzed and compared.

RESULTS

The mean number of injections in group 2 was less than in group 1 (6 vs 8 respectively, <0.05). There were no significant differences in CMVR recurrence, complication and vision recovery rate.

CONCLUSION

Incorporating aqueous humor IL-8 level into the criteria of CMVR treatment decision can safely and effectively reduce the number of intravitreal injections needed and can be used as important indicators to assess treatment endpoint.

摘要

目的

基于房水指标探索异基因骨髓造血干细胞移植(allo-HSCT)后巨细胞病毒视网膜炎(CMVR)患者的最佳治疗方法。

方法

这是一项随机对照研究,共纳入 35 只眼。这些眼被随机分为 1:1 比例的标准治疗组(第 1 组,以房水 CMV-DNA 载量<10 拷贝/ml 作为治疗终点)和白细胞介素(IL)-8 组(第 2 组,以房水 IL-8 水平<30pg/ml 或 CMV-DNA 载量<10 拷贝/ml 作为治疗终点),两组均接受抗病毒玻璃体内注射。分析和比较注射次数、CMVR 复发率、并发症发生率和视力变化。

结果

第 2 组的平均注射次数少于第 1 组(分别为 6 次和 8 次,<0.05)。CMVR 复发、并发症和视力恢复率无显著差异。

结论

将房水 IL-8 水平纳入 CMVR 治疗决策标准,可以安全有效地减少玻璃体内注射次数,并可作为评估治疗终点的重要指标。

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