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使用更昔洛韦植入物治疗的巨细胞病毒性视网膜炎患者的长期随访

Long-Term Follow-up of Patients With Cytomegalovirus Retinitis Treated With a Ganciclovir Implant.

作者信息

Caranfa Jonathan T, Duker Jay S

机构信息

Retina Service, New England Eye Center, Tufts Medical Center, Boston, MA, USA.

出版信息

J Vitreoretin Dis. 2024 Apr 14;8(4):415-420. doi: 10.1177/24741264241247610. eCollection 2024 Jul-Aug.

Abstract

To assess the long-term safety and clinical outcomes of a ganciclovir intravitreal implant in patients with cytomegalovirus (CMV) retinitis. A retrospective study was performed of patients with CMV retinitis treated with a ganciclovir intravitreal implant. The study included 13 patients (16 eyes) previously treated with a ganciclovir intravitreal implant. The mean time since the last implant placement was 21.3 years and the mean total duration of follow-up, 22.7 years. Visual acuity (VA) ranged from 20/25 to light perception, with 56% of eyes maintaining a VA of 20/60 or better at the most recent follow-up examination. Common ocular complications included epiretinal membrane (38%), macular fibrosis/scarring (25%), retinal detachment (RD) (25%), implant dislocation (25%), and immune reactivation uveitis (19%). Intraocular surgery was required in 10 eyes (63%), with the most frequent being cataract extraction (31%), pars plana vitrectomy (PPV) for implant removal (19%), and PPV for RD (13%). Results show the long-term safety of the ganciclovir intravitreal implant despite its residual inactive inert shell. Complication rates are consistent with those expected from infectious sequelae.

摘要

评估更昔洛韦玻璃体内植入物在巨细胞病毒(CMV)视网膜炎患者中的长期安全性和临床结局。对接受更昔洛韦玻璃体内植入物治疗的CMV视网膜炎患者进行了一项回顾性研究。该研究纳入了13例(16只眼)先前接受过更昔洛韦玻璃体内植入物治疗的患者。自上次植入以来的平均时间为21.3年,平均总随访时间为22.7年。视力(VA)范围从20/25至光感,在最近一次随访检查中,56%的眼睛视力保持在20/60或更好。常见的眼部并发症包括视网膜前膜(38%)、黄斑纤维化/瘢痕形成(25%)、视网膜脱离(RD)(25%)、植入物脱位(25%)和免疫反应性葡萄膜炎(19%)。10只眼(63%)需要进行眼内手术,最常见的是白内障摘除术(31%)、为取出植入物进行的玻璃体切割术(PPV)(19%)以及为治疗视网膜脱离进行的PPV(13%)。结果显示,尽管更昔洛韦玻璃体内植入物存在残留的无活性惰性外壳,但仍具有长期安全性。并发症发生率与感染后遗症预期的发生率一致。

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Cytomegalovirus Retinitis: A Review.巨细胞病毒性视网膜炎:综述
J Ocul Pharmacol Ther. 2017 May;33(4):224-234. doi: 10.1089/jop.2016.0140. Epub 2017 Mar 29.
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CMV retinitis in the era of HAART.高效抗逆转录病毒治疗时代的巨细胞病毒性视网膜炎
Ocul Immunol Inflamm. 1999 Dec;7(3-4):231-5. doi: 10.1076/ocii.7.3.231.4008.

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