Clinical features of 55 cases of cytomegalovirus retinitis in Japan
Purpose
Cytomegalovirus (CMV) retinitis is caused by reactivation of latent CMV infection in the host under immunosuppressive conditions. We report the clinical features and outcome of cases of CMV retinitis diagnosed at our hospital.
Methods
We retrospectively reviewed the medical records and evaluated the patient background, underlying condition, systemic immune status, surgical method, and visual outcome of 55 patients (72 eyes) between 2003 and 2022 at the Department of Ophthalmology, Tokyo Medical University.
Results
The mean age at onset of retinitis was 53.4 ± 18.3 years, and male-to-female ratio was 42:13. The mean time from onset of ocular symptoms to diagnosis was 100.9 ± 120.7 days. Regarding underlying conditions, 25 patients were HIV-positive, 12 had malignant lymphoma, 6 had diabetes, 5 had leukemia, 4 had collagen disease, 2 had lung cancer and breast cancer, respectively, and 4 had other diseases. (> 1 underlying condition in some patients). The median CD4+ T-cell count at onset of retinitis was 96 ± 226.9 cells/μl. The median number of CMV-DNA copies in aqueous humor measured by real-time PCR was 4.1 x 10^4 ± 8.0 x 10^5 copies/ml (n = 26). Eighteen eyes required vitrectomy and 13 eyes were treated with encircling concomitantly. LogMAR values of initial and final visual acuity were 0.47 ± 0.70 and 0.67 ± 0.90, respectively, with no significant difference. The median follow-up period was 15.0 ± 56.7 months.
Conclusion
CMV retinitis may develop from a variety of underlying conditions other than HIV infection. As it takes a long time to diagnose the disease from onset, visual outcome is often poor. Early diagnosis as well as effective anti-viral treatment are essential to improve visual outcome.
Conflict of interest
No
Authors 1
Last name
WAKATSUKI
Initials of first name(s)
K
Department
Tokyo Medical Univercity Hospital Hospital
City
Tokyo
Country
Japan
Authors 2
Last name
USUI
Initials of first name(s)
Y
Department
Tokyo Medical Univercity Hospital
City
Tokyo
Country
Japan
Authors 3
Last name
TSUBOTA
Initials of first name(s)
K
Department
Tokyo Medical Univercity Hospital
City
Tokyo
Country
Japan
Authors 4
Last name
UMAZUME
Initials of first name(s)
A
Department
Tokyo Medical Univercity Hospital
City
Tokyo
Country
Japan
Authors 5
Last name
GOTO
Initials of first name(s)
H
Department
Tokyo Medical Univercity Hospital
City
Tokyo
Country
Japan
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