Alkhuraiji Arwa A, Refka Mohammed N, Aldebasi Tariq, Elzahrani Mohamed R, Alotaibi Mohammed D, Alhazzazi Mohammed A, Adhi Mohammad I
Department of Ophthalmology, King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.
Middle East Afr J Ophthalmol. 2024 Dec 2;30(4):220-228. doi: 10.4103/meajo.meajo_55_24. eCollection 2023 Oct-Dec.
To describe the nature and response of cytomegalovirus (CMV) retinitis in human immunodeficiency virus (HIV)-negative patients with hematological malignancies and other immunosuppressive causes.
This is retrospective case series of CMV retinitis patients with known immunocompromised status and negative HIV results. Patients' data were reviewed for demographics, causes of the immunosuppressed status, concomitant systemic CMV infection, and its management. Ophthalmic findings included visual acuity (VA), anterior and posterior segments findings, CMV retinitis patterns and extensions, medications, number of intravitreal injections, fundus photographs, and CMV retinitis complications.
During a study period of 2 years, 17 eyes of 9 patients were diagnosed with CMV retinitis with detected CMV in blood tests. Indolent granular retinitis pattern was found in 4 eyes (23.5%), and the fulminant necrotizing pattern in another 4 eyes (23.5%). In 1 eye (5.9%), frosted branch angiitis was observed. A mixed pattern between granular and necrotizing retinitis was seen in 4 eye (23.5%). The majority (n 11, 64.7%) of the affected eyes had an extensive retinal involvement (zone 1-3). Only two eyes had no macular involvement (11.8%). A large percentage of the included patients had controlled disease course with stable vision. Out of the studied 17 eyes, deterioration in terms of VA was seen in five eyes. In two patients, the disease course was complicated by vitreous hemorrhage.
In the majority of the patients with HIV-negative tests who received intravitreal and/or systemic anti-CMV medications, the clinical course of CMV retinitis was controlled with final stable vision.
描述人类免疫缺陷病毒（HIV）阴性的血液系统恶性肿瘤及其他免疫抑制性病因患者中巨细胞病毒（CMV）视网膜炎的性质及反应。
这是一项针对已知免疫功能低下状态且HIV检测结果为阴性的CMV视网膜炎患者的回顾性病例系列研究。对患者数据进行回顾，内容包括人口统计学信息、免疫抑制状态的病因、合并的全身性CMV感染及其治疗情况。眼科检查结果包括视力（VA）、眼前段和后段检查结果、CMV视网膜炎的类型及范围、用药情况、玻璃体内注射次数、眼底照片以及CMV视网膜炎并发症。
在为期2年的研究期间，9例患者的17只眼被诊断为CMV视网膜炎，血液检测中检测到CMV。4只眼（23.5%）表现为惰性颗粒状视网膜炎类型，另外4只眼（23.5%）为暴发性坏死性类型。1只眼（5.9%）观察到霜样树枝状视网膜血管炎。4只眼（23.5%）表现为颗粒状和坏死性视网膜炎的混合类型。大多数受累眼（11只，64.7%）视网膜广泛受累（1 - 3区）。只有2只眼未累及黄斑（11.8%）。大部分纳入患者的病程得到控制，视力稳定。在研究的17只眼中，5只眼视力出现恶化。2例患者的病程并发玻璃体积血。
在大多数接受玻璃体内和/或全身性抗CMV药物治疗的HIV检测阴性患者中，CMV视网膜炎的临床病程得到控制，最终视力稳定。
