接受免疫调节治疗的患者出现巨细胞病毒性前葡萄膜炎和闭塞性视网膜血管炎，无视网膜炎。
Cytomegalovirus anterior uveitis and occlusive retinal vasculitis without retinitis in a patient on immunomodulatory therapy.
作者信息
Fabozzi Lorenzo, Testi Ilaria, De Benito-Llopis Laura, Pavesio Carlos
机构信息
Department of Uveitis, Moorfields Eye Hospital, National Health Service Foundation Trust, London, UK.
Rheumatology Department, Great Ormond Street Hospital for Children, London, UK.
出版信息
J Ophthalmic Inflamm Infect. 2023 Aug 4;13(1):34. doi: 10.1186/s12348-023-00356-z.
PURPOSE
To describe unusual clinical features and therapeutic management of a case of cytomegalovirus (CMV) ocular disease in a patient on immunomodulatory therapy.
SETTING/VENUE: Moorfields Eye Hospital NHS Foundation Trust, London, UK.
METHODS
Medical history, clinical findings, investigation results, and multimodal imaging were retrospectively collected.
RESULTS
A 61-year-old, South-East Asian man, developed CMV-related endotheliitis and occlusive retinal vasculitis, diagnosed by wide-angle fluorescein angiography. No retinitis was present on the fundus examination. Suspicion of CMV etiology was based on anterior segment findings, especially the presence of coin-shaped endothelial lesions. The diagnosis was confirmed by aqueous polymerase chain reaction (PCR) analysis which was positive for CMV DNA. The combined use of topical and systemic valganciclovir resulted in significant improvement of the picture.
CONCLUSIONS
CMV can manifest in the eye as occlusive retinal vasculitis without the presence of typical retinitis.
目的
描述1例接受免疫调节治疗患者的巨细胞病毒（CMV）眼病的异常临床特征及治疗处理。
地点/场所：英国伦敦穆尔菲尔兹眼科医院国民保健服务信托基金。
方法
回顾性收集病史、临床检查结果、检查结果及多模式影像学资料。
结果
一名61岁东南亚男性发生CMV相关性内皮炎和闭塞性视网膜血管炎，通过广角荧光素血管造影确诊。眼底检查未发现视网膜炎。基于眼前节表现，尤其是钱币状内皮病变的存在，怀疑为CMV病因。房水聚合酶链反应（PCR）分析证实诊断，CMV DNA呈阳性。局部和全身联合使用缬更昔洛韦使病情显著改善。
结论
CMV可在眼部表现为闭塞性视网膜血管炎，而无典型视网膜炎。
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