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先天性巨细胞病毒(CMV)感染的新生儿在新生儿期是否需要进行及时的常规眼科检查?

Is there room for prompt routine ophthalmic examination in neonates with congenital cytomegalovirus (CMV) infection during the neonatal period?

机构信息

Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.

Ruth and Bruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Int Ophthalmol. 2023 Oct;43(10):3667-3672. doi: 10.1007/s10792-023-02775-2. Epub 2023 Jul 7.

Abstract

PURPOSE

To establish the clinical necessity of routine targeted ophthalmic examination of newborns with congenital cytomegalovirus (CMV) infection during the neonatal period.

METHODS

This retrospective study included consecutive neonates that were referred for ophthalmological screening within the context of a proven congenital CMV infection. The presence of CMV-related ocular and systemic findings was determined.

RESULTS

Among the 91 patients included in this study, 72 (79.12%) were symptomatic with one or more of the following manifestations: abnormal brain ultrasound (42; 46.15%), small for gestational age (29; 31.87%), microcephaly (23; 25.27%), thrombocytopenia (14; 15.38%), sensory neural hearing loss (13; 14.29%), neutropenia (12; 13.19%), anemia (4; 4.4%), skin lesions (4; 4.4%), hepatomegaly (3; 3.3%), splenomegaly (3; 3.3%), direct hyperbilirubinemia (2; 2.2%). Not one single neonate in this cohort had any of the ocular findings surveyed.

CONCLUSION

The presence of ophthalmological findings among neonates with congenital CMV infection during the neonatal period is infrequent, suggesting that routine ophthalmological screening may be safely deferred for the post-neonatal period.

摘要

目的

确定新生儿期先天性巨细胞病毒 (CMV) 感染新生儿常规进行靶向眼科检查的临床必要性。

方法

本回顾性研究纳入了因已确诊先天性 CMV 感染而接受眼科筛查的连续新生儿。确定存在与 CMV 相关的眼部和全身表现。

结果

在这项研究中,91 名患者中,72 名(79.12%)出现以下一种或多种症状:异常脑超声(42 例;46.15%)、小于胎龄儿(29 例;31.87%)、小头畸形(23 例;25.27%)、血小板减少症(14 例;15.38%)、感觉神经性听力损失(13 例;14.29%)、中性粒细胞减少症(12 例;13.19%)、贫血(4 例;4.4%)、皮肤损伤(4 例;4.4%)、肝肿大(3 例;3.3%)、脾肿大(3 例;3.3%)、直接高胆红素血症(2 例;2.2%)。在该队列中,没有任何新生儿存在所调查的眼部表现。

结论

新生儿期先天性 CMV 感染患儿的眼部表现罕见,表明新生儿期后可安全推迟常规眼科筛查。

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