Clinical characteristics and treatment of cytomegalovirus retinitis in leukemia_Chinese Journal of Ocular Fundus Diseases

Authors：

 Zhu Xuefei , Lu Yunfeng , Lu Peirong , Xu Yao

Department of Ophthalmology, The First Affiliated Hospital of Soochow Universtity, Suzhou 215006, China;

Corresponding author：

Zhu Xuefei, Email: snowflying_z@126.com

Keywords：

Cytomegalovirus retinitis/diagnosis; Cytomegalovirus retinitis/treatment; Leukemia

DOI：

10.3760/cma.j.issn.1005-1015.2018.01.011

Video：

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Objective To observe the clinical characteristics and treatment of cytomegalovirus retinitis (CMVR) in leukemia patients. Methods This is a retrospective analysis. Seven leukemia patients (13 eyes) with CMVR were studied. All patients underwent examinations of visual acuity, slit lamp microscope, ophthalmoscope, color fundus photography, peripheral blood CD4+T cell count and serum/aqueous CMV-DNA test. All patients were treated with ganciclovir or zoledronic acid combined with intravitreal injection of ganciclovir. The follow-up period was 3-14 months. Results Six patients were treated with hematopoietic stem cell transplantation and 1 patient was with chronic leukemia. All patients were CMV-DNA positive for serum, and 18.5% (2/7) for aqueous humor. CMVR in leukemia patients showed mild anterior segment inflammation, ocular fundus with irregular yellowish-white retinal necrosis and radial hemorrhage (7 eyes). Some (2 eyes) also shoed gray and white granular retinal infiltrates. Intravenous ganciclovir/zoledronic acid combined with intravitreal injection of high concentration ganciclovir was an effective treatment, while systemic corticosteroids were effective in reducing vitreous opacity. Conclusions CMVR is characterized by progressive necrotic retinitis with hemorrhage and vasculitis. Intravenous ganciclovir/zoledronic acid combined with intravitreal injection of ganciclovir is effective in the treatment of CMVR with leukemia.

Citation： Zhu Xuefei, Lu Yunfeng, Lu Peirong, Xu Yao. Clinical characteristics and treatment of cytomegalovirus retinitis in leukemia. Chinese Journal of Ocular Fundus Diseases, 2018, 34(1): 43-46. doi: 10.3760/cma.j.issn.1005-1015.2018.01.011 Copy

1.	杨培增. 巨细胞病毒性视网膜炎[M]//李凤鸣. 中华眼科学. 2版. 北京: 人民卫生出版社, 2004: 1972-1973.Yang PZ. Cytomegalovirus retinitis [M]//Li FM. Chinese ophthalmology. 2nd. Beijing: People's Medical Publishing House, 2004: 1972-1973.
2.	Chiotan C, Radu L, Serban R, et al. Cytomegalovirus retinitis in HIV/AIDS patients [J]. J Med Life, 2014, 7(2): 237-240.
3.	Beňová A, Brichová M, Svozílková P, et al. Cytomegalovirus retinitis in HIV negative patients-retrospective study[J]. Cesk Slov Oftalmol, 2013, 69(6): 227-234.
4.	朱瑞琳, 李骏, 郭春英, 等. 白血病造血干细胞移植手术后巨细胞病毒性视网膜炎二例[J]. 中华眼底病杂志, 2012, 28(6): 638-640. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.023.Zhu RL, Li J, Guo CY, et al. Two cases of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation. [J]. Chin J Ocul Fundus Dis, 2012, 28(6): 638-640. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.023.
5.	曹丹, 费文雷, 杨大卫, 等. 异基因骨髓造血干细胞移植手术后巨细胞病毒视网膜炎一例. 中华眼底病杂志, 2017, 33(2): 195-196. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.021.Cao D, Fei WL, Yang DW, et al. A case of cytomegalovirus retinopathy after allogeneic bone marrow hematopoietic stem cell transplantation. [J]. Chin J Ocul Fundus Dis, 2017, 33(2): 195-196. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.021.
6.	邹绚, 戴荣平, 董方田. 系统性红斑狼疮患者全身应用免疫抑制剂引发巨细胞病毒性视网膜炎一例[J]. 中华眼底病杂志, 2013, 49(5): 462-463. DOI: 10.3760/cma.j.issn.0412-4081.2013.05.021.Zhou X, Dai RP, Dong FT. A case of cytomegalovirus retinitis caused by systemic immunosuppressive agents in systemic lupus erythematosus patients [J]. Chin J Ocul Fundus Dis, 2013, 49(5): 462-463. DOI: 10.3760/cma.j.issn.0412-4081.2013.05.021.
7.	Xhaard A, Robin M, Scieux C, et al. Increased incidence of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation [J]. Transplantation, 2007, 83(1): 80-83. DOI: 10.1097/01.tp.0000239512.94181.e9.
8.	Freigassner P, Ardjomand N, Radner H, et al. Coinfection of the retina by Epstein-Barr virus and cytomegalovirus in an AIDS patient[J]. J Neuroophthalmol, 2017, 37(1): 43-47. DOI: 10.1097/WNO.0000000000000433.
9.	Banker AS. Posterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome[J]. Indian J Ophthalmol, 2008, 56(5): 377-383.
10.	Suzuki N, Kudoh T, Mizue N, et al. CMV retinitis after cessation of ganciclovir therapy for CMV antigenemia in an unrelated BMT recipient[J]. Bone Marrow Transplant, 1998, 22(9): 931-932. DOI: 10.1038/sj.bmt.1701441.
11.	王伟伟, 叶俊杰. 获得性免疫缺陷综合征并发巨细胞病毒性视网膜炎的药物治疗现状和进展[J]. 中华眼科杂志, 2010, 46(12): 1146-1152. DOI: 10.3760/cma.j.issn.0412-4081.2010.12.025.Wang WW, Ye JJ. Present status and advances in pharmacotherapy for cytomegalovirus retinitis associated with acquired immunodeficiency syndrome[J]. Chin J Ophthalmol, 2010, 46(12): 1146-1152. DOI: 10.3760/cma.j.issn.0412-4081.2010.12.025.
12.	Arevalo JF, Garcia RA, Mendoza AJ. High-dose (5000-microg) intravitreal ganciclovir combined with highly active antiretroviral therapy for cytomegalovirus retinitis in HIV-infected patients in Venezuela[J]. Eur J Ophthalmol, 2005, 15(5): 610-618.

1. 杨培增. 巨细胞病毒性视网膜炎[M]//李凤鸣. 中华眼科学. 2版. 北京: 人民卫生出版社, 2004: 1972-1973.Yang PZ. Cytomegalovirus retinitis [M]//Li FM. Chinese ophthalmology. 2nd. Beijing: People's Medical Publishing House, 2004: 1972-1973.
2. Chiotan C, Radu L, Serban R, et al. Cytomegalovirus retinitis in HIV/AIDS patients [J]. J Med Life, 2014, 7(2): 237-240.
3. Beňová A, Brichová M, Svozílková P, et al. Cytomegalovirus retinitis in HIV negative patients-retrospective study[J]. Cesk Slov Oftalmol, 2013, 69(6): 227-234.
4. 朱瑞琳, 李骏, 郭春英, 等. 白血病造血干细胞移植手术后巨细胞病毒性视网膜炎二例[J]. 中华眼底病杂志, 2012, 28(6): 638-640. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.023.Zhu RL, Li J, Guo CY, et al. Two cases of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation. [J]. Chin J Ocul Fundus Dis, 2012, 28(6): 638-640. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.023.
5. 曹丹, 费文雷, 杨大卫, 等. 异基因骨髓造血干细胞移植手术后巨细胞病毒视网膜炎一例. 中华眼底病杂志, 2017, 33(2): 195-196. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.021.Cao D, Fei WL, Yang DW, et al. A case of cytomegalovirus retinopathy after allogeneic bone marrow hematopoietic stem cell transplantation. [J]. Chin J Ocul Fundus Dis, 2017, 33(2): 195-196. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.021.
6. 邹绚, 戴荣平, 董方田. 系统性红斑狼疮患者全身应用免疫抑制剂引发巨细胞病毒性视网膜炎一例[J]. 中华眼底病杂志, 2013, 49(5): 462-463. DOI: 10.3760/cma.j.issn.0412-4081.2013.05.021.Zhou X, Dai RP, Dong FT. A case of cytomegalovirus retinitis caused by systemic immunosuppressive agents in systemic lupus erythematosus patients [J]. Chin J Ocul Fundus Dis, 2013, 49(5): 462-463. DOI: 10.3760/cma.j.issn.0412-4081.2013.05.021.
7. Xhaard A, Robin M, Scieux C, et al. Increased incidence of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation [J]. Transplantation, 2007, 83(1): 80-83. DOI: 10.1097/01.tp.0000239512.94181.e9.
8. Freigassner P, Ardjomand N, Radner H, et al. Coinfection of the retina by Epstein-Barr virus and cytomegalovirus in an AIDS patient[J]. J Neuroophthalmol, 2017, 37(1): 43-47. DOI: 10.1097/WNO.0000000000000433.
9. Banker AS. Posterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome[J]. Indian J Ophthalmol, 2008, 56(5): 377-383.
10. Suzuki N, Kudoh T, Mizue N, et al. CMV retinitis after cessation of ganciclovir therapy for CMV antigenemia in an unrelated BMT recipient[J]. Bone Marrow Transplant, 1998, 22(9): 931-932. DOI: 10.1038/sj.bmt.1701441.
11. 王伟伟, 叶俊杰. 获得性免疫缺陷综合征并发巨细胞病毒性视网膜炎的药物治疗现状和进展[J]. 中华眼科杂志, 2010, 46(12): 1146-1152. DOI: 10.3760/cma.j.issn.0412-4081.2010.12.025.Wang WW, Ye JJ. Present status and advances in pharmacotherapy for cytomegalovirus retinitis associated with acquired immunodeficiency syndrome[J]. Chin J Ophthalmol, 2010, 46(12): 1146-1152. DOI: 10.3760/cma.j.issn.0412-4081.2010.12.025.
12. Arevalo JF, Garcia RA, Mendoza AJ. High-dose (5000-microg) intravitreal ganciclovir combined with highly active antiretroviral therapy for cytomegalovirus retinitis in HIV-infected patients in Venezuela[J]. Eur J Ophthalmol, 2005, 15(5): 610-618.

Chinese Journal of Ocular Fundus Diseases

Clinical characteristics and treatment of cytomegalovirus retinitis in leukemia

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