Kwon Hye-Ji, Son Gisung, Lee Joo-Yong, Kim June-Gone, Kim Yoon-Jeon
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Retinal Service, Hangil Eye Hospital, Incheon 21388, Korea.
Microorganisms. 2021 May 21;9(6):1114. doi: 10.3390/microorganisms9061114.
We evaluated the incidence and characteristics of eyes with cytomegalovirus (CMV) retinitis according to the occurrence of cystoid macular edema (CME) and identified the risk factors of its occurrence. Patients diagnosed with CMV retinitis and examined using optical coherence tomography were classified according to the development of CME. The CME group was further divided according to the presence of active retinitis at the time of CME development. The demographics, serologic findings, ophthalmic presentations, ocular treatments, and visual prognosis were compared. CME was identified in 25 eyes (17 eyes with active retinitis and 8 eyes with inactive retinitis) out of the 67 eyes with CMV retinitis. Visual acuity was worse in the CME group than in the non-CME group. The CME group had longer CMV viremia duration, zone 1 involvement, and larger extent of CMV retinitis. While CME with concurrent active retinitis developed in eyes with direct foveal involvement of retinitis in the acute phase and required more ganciclovir injections after CME development, CME without active retinitis developed in eyes with larger extents of involvement and more intravitreal ganciclovir injections before CME development. Zone 1 involvement and longer CMV viremia duration were independently associated with the occurrence of CME. CME, which caused visual deterioration, developed in considerable patients with CMV retinitis and had different characteristics according to the presence of active retinitis.
我们根据黄斑囊样水肿（CME）的发生情况评估了巨细胞病毒（CMV）视网膜炎患者眼部的发病率及特征，并确定了其发生的危险因素。将诊断为CMV视网膜炎并接受光学相干断层扫描检查的患者，根据CME的发生情况进行分类。CME组再根据CME发生时活动性视网膜炎的情况进一步细分。比较了两组患者的人口统计学特征、血清学检查结果、眼科表现、眼部治疗情况及视力预后。在67例CMV视网膜炎患者中，25只眼出现了CME（17只眼伴有活动性视网膜炎，8只眼伴有非活动性视网膜炎）。CME组的视力比非CME组差。CME组的CMV病毒血症持续时间更长，累及1区，CMV视网膜炎范围更大。伴有活动性视网膜炎的CME发生于急性期视网膜直接累及黄斑中心凹的患者，且在CME发生后需要更多次更昔洛韦注射；不伴有活动性视网膜炎的CME发生于累及范围更大且在CME发生前接受更多次玻璃体内更昔洛韦注射的患者。累及1区和更长的CMV病毒血症持续时间与CME的发生独立相关。CME在相当一部分CMV视网膜炎患者中出现，导致视力下降，且根据活动性视网膜炎的情况具有不同特征。
