Department of Ophthalmology and Clinical Center of Optometry, Peking University People's Hospital, Beijing, China.
Eye Diseases and Optometry Institute, Peking University People's Hospital, Beijing, China.
Retina. 2021 Jul 1;41(7):1526-1532. doi: 10.1097/IAE.0000000000003040.
To report the incidence and clinical features of neovascular complications from cytomegalovirus (CMV) necrotizing retinopathy in patients after haploidentical hematopoietic stem cell transplantation.
Thirty-nine patients (58 eyes) of CMV necrotizing retinopathy after haploidentical hematopoietic stem cell transplantation in our institute between January 2018 and June 2020 were retrospectively reviewed, and cases that developed neovascular complications during follow-up were identified and described.
Two (2 eyes) cases that developed neovascular glaucoma from CMV necrotizing retinopathy were identified. Both of them manifested as granular peripheral retinitis, panretinal occlusive vasculitis, and some degree of intraocular inflammation, which were consistent with chronic retinal necrosis. Insidious progression of isolated immune-mediated occlusive vasculitis that could only be observed on fundus fluorescein angiography without active retinitis or intraocular inflammation was recognized to be the cause in one of two cases.
Neovascular glaucoma developed in 5.1%/cases and 3.4%/eyes complicated by CMV chronic retinal necrosis and vasculitis in patients after haploidentical hematopoietic stem cell transplantation, which warrants the needs for long-term follow-up. Immune-mediated CMV vasculitis could be an isolated manifestation in patients with a minimal immune deviation and may only be found on fundus fluorescein angiography, which emphasizes the importance of fundus fluorescein angiography on a regular basis during follow-up.
报告单倍体造血干细胞移植后巨细胞病毒（CMV）坏死性视网膜炎患者发生新生血管并发症的发生率和临床特征。
回顾性分析 2018 年 1 月至 2020 年 6 月在我院接受单倍体造血干细胞移植后发生 CMV 坏死性视网膜炎的 39 例（58 只眼）患者的临床资料，对随访中发生新生血管并发症的病例进行描述和分析。
发现 2 例（2 只眼）CMV 坏死性视网膜炎患者发生新生血管性青光眼。均表现为颗粒状周边性视网膜炎、全视网膜闭塞性血管炎和一定程度的眼内炎症，符合慢性视网膜坏死。其中 1 例患者眼底荧光血管造影检查发现存在隐匿性进展的单纯免疫介导性闭塞性血管炎，而眼底或眼内炎症无明显活动，考虑为其发病原因。
单倍体造血干细胞移植后发生 CMV 慢性视网膜坏死和血管炎的患者中，分别有 5.1%/例和 3.4%/眼发生新生血管性青光眼，需要长期随访。免疫介导的 CMV 血管炎可能是免疫偏离最小的患者的孤立表现，仅在眼底荧光血管造影检查中发现，这强调了在随访过程中定期进行眼底荧光血管造影检查的重要性。
