Long-term Follow-up of Cytomegalovirus Retinitis in Non-HIV Immunocompromised Patients: Clinical Features and Visual Prognosis

Iu, Lawrence P.; Fan, Michelle; Lau, Jordy K.; Chan, Thomas S. Y.; Kwong, Yok–Lam; Wong, Ian Yu‐Hong

doi:10.1016/j.ajo.2016.03.015

Cited by 48 publications

(62 citation statements)

References 22 publications

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“…There is a strong association between CMV viremia as well as CMV DNAemia (PCR) in serum and CMVR (Hansen et al 1994;Freeman 1996;Fezza et al 2001;Iu et al 2016). Furthermore, systemic testing methods for CMV are routinely used to monitor patients for reactivation and response to treatment in the haematological settings.…”

Section: Diagnosis Of Cmvrmentioning

confidence: 99%

“…Furthermore, systemic testing methods for CMV are routinely used to monitor patients for reactivation and response to treatment in the haematological settings. There are other centres reporting confirmation of CMVR based on systemic testing (Mota et al 2011;Jeon et al 2012;Kobayashi et al 2012;Davis et al 2013;Samia et al 2014;Iu et al 2016). There are other centres reporting confirmation of CMVR based on systemic testing (Mota et al 2011;Jeon et al 2012;Kobayashi et al 2012;Davis et al 2013;Samia et al 2014;Iu et al 2016).…”

Section: Diagnosis Of Cmvrmentioning

confidence: 99%

“…Also, Iu et al (2016) recently described the outcome of combined systemic (intravenous ganciclovir, intravenous foscarnet or oral valganciclovir) and intravitreal (ganciclovir and/or foscarnet) anti-CMV therapy in 13 HIV-negative patients with CMVR. The mean duration of systemic therapy was 12 weeks (range, 0.6-19.3 weeks).…”

Section: Treatment and Outcomementioning

confidence: 99%

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Cytomegalovirus retinitis in HIV‐negative patients – associated conditions, clinical presentation, diagnostic methods and treatment strategy

Shapira

Vishnevskia‐Dai

2017

Acta Ophthalmologica

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In recent years, numerous reports have tied cytomegalovirus retinitis (CMVR) with multiple systemic conditions in the absence of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). These range from reports in apparently healthy individuals, through conditions rendering limited immune dysfunction such as advanced age and diabetes mellitus, and finally severe immune dysfunction such as in haematological and rheumatological conditions. Reports are also emerging, suggesting that induced local ocular immunosuppression is a risk factor for CMVR. We herein present a comprehensive collection of the accumulated findings regarding CMVR in non-HIV patients. We summarize the spectrum of underlying morbidity that has been associated with CMVR, its clinical presentation, diagnostic methods and treatment choice in the attempt to suggest the optimal treatment strategy in this complicated and diverse patient population which is still currently lacking a consensus.

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Section: Diagnosis Of Cmvrmentioning

confidence: 99%

Section: Diagnosis Of Cmvrmentioning

confidence: 99%

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Cytomegalovirus retinitis in HIV‐negative patients – associated conditions, clinical presentation, diagnostic methods and treatment strategy

Shapira

Vishnevskia‐Dai

2017

Acta Ophthalmologica

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“…In two small series of non-HIV patients with CMVR, the mortality rate ranged from 11.7–23/100 PY. [22, 89]…”

Section: Mortalitymentioning

confidence: 99%

“…The centerstone of short and long-term disease control of CMVR is immune reconstitution, whether through cART in HIV patients or modulation of systemic immunosuppressive drugs or immune reconstitution in hematopoetic stem cell transplantation [7, 89]. Among HIV-infected patients, immune recovery decreases the risk of ocular morbidity, vision loss and death [10].…”

Section: Treatmentmentioning

confidence: 99%

Cytomegalovirus Retinitis in the Post-cART Era

Port

Alabi

Koenig

et al. 2018

Curr Ophthalmol Rep

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Purpose of review: To review the epidemiology, diagnosis, and management of cytomegalovirus retinitis (CMVR) in the post-combined antiretroviral era (cART) era. Recent findings: Although cART has dramatically reduced CMVR incidence and morbidity in the HIV population, CMVR continues to cause significant vision loss in both HIV and non-HIV patients, especially amongst patients without immune reconstitution. Advances in imaging including ultra-widefield fundus and autofluorescence imaging, optical coherence tomography, and adaptive optics may reflect CMVR activity; however, the diagnosis remains a clinical one. There have been minimal advances in therapy, with several agents no longer available due to market concerns. Summary: Despite reduced incidence and morbidity in the post-cART HIV population, CMVR continues to cause vision loss amongst HIV and non-HIV patients. Diagnosis remains primarily clinical, and therapy centers upon immune reconstitution along with systemic and/or intravitreal antivirals. Further studies are necessary to determine whether advanced imaging can influence management, and whether novel antiviral agents or adoptive immune transfer have a role in treatment of drug-resistance CMVR.

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