ABSTRACT
Objective To observe the image characteristics of OCT in patients of acquired immunodeficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR).Methods Thirty-nine eyes of 26 patients of AIDS with CMVR diagnosed in Department of ophthalmology of Beijing Ditan Hospital Capital Medical University from January 2015 to December 2017 were included in this study.All the patients were males,with the mean age of 33.12± 9.87 years.All the patients underwent the OCT examination by Spectralis HRA+OCT.The locations of scanning were macular,optical papilla and posterior pole of retina with retinitis.Typical images were saved and analyzed.Results The OCT pathological changes of CMVR included increase of retinal thickness and reflex of retina,indiscernible retinal layers,irregularity or absent external limiting membrane and/or ellipsoid zone,hyperreflective spots,vitreous cells.Among 39 eyes,there were 6 eyes with strong point-like reflection in the outer layer of retina around the lesion,31 eyes (79.49％) with strong point-like reflection in the full layer of retina,25 eyes (64.10％) with lesion involved macular area,34 eyes (87.17％) with vitreous cells.Conclusions OCT images of the eyes with AIDS with CMVR were characterized by lesions involving the whole retina.Absent ellipsoid zone or structural changes can be seen in the affected areas and peripheral areas of the lesion.
ABSTRACT
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.
ABSTRACT
Objective To observe ocular manifestations of acquired immunodeficiency syndrome (AIDS). Methods Fourty-two AIDS patients (66 eyes)with ocular complaints received examinations of visual acuity, slit-lamp microscope, ophthalmoscope and fundus fluorescence angiography (FFA). The results were retrospectively analyzed. ResultsThere are five types of ocular findings, including cytomegalovirus (CMV) retinitis (37 eyes, 56.0%), retinal microvasculopathy of human immunodeficiency virus (21 eyes, 32.0% ), optic nerve diseases (three eyes, 4.5 % ), retinal neuroepithelial layer detachment (two eyes, 3.0%) and uveitis (three eyes, 4.5%). Conclusions The common ocular manifestations showed progressive necrotic retinitis, retinal hemorrhage and retinal vasculitis and attenuated, cotton-wool spots in AIDS patients.