Branch retinal artery occlusion (BRAO) combined with branch retinal vein occlusion (BRVO) and optic disc neovascularization associated with HIV and CMV retinitis

Conway, Mandi D.; Tong, Peter C.Y.; Olk, R. Joseph

doi:10.1007/bf00132694

Cited by 35 publications

(15 citation statements)

References 29 publications

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“…A role of TSP-1 or TSP-2 in patients with HCMV retinitis had not yet been studied. However, virus-induced down-regulation of TSP-1 and/or TSP-2 could be important for the neovascularization of the optic disc that has been observed in some patients with HCMV retinitis [41,42]. In addition, TSP-1 was found to be a potent inhibitor of HIV-1 infectivity [43].…”

Section: Discussionmentioning

confidence: 95%

Cytomegalovirus Infection Decreases Expression of Thrombospondin‐1 and ‐2 in Cultured Human Retinal Glial Cells: Effects of Antiviral Agents

Činátl¹,

Bittoova²,

Margraf³

et al. 2000

J INFECT DIS

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In fibroblasts, infection with human cytomegalovirus (HCMV) inhibits expression of the extracellular matrix proteins thrombospondin-1 and -2 (TSP-1 and TSP-2). These effects may depend on expression of HCMV immediate-early (IE) genes, which are activated by cellular transcription factor NF-kappaB. The influence of HCMV infection on TSP-1 and TSP-2 expression and the ability of different antiviral drugs to prevent these cellular changes in permissive cultures of human retinal glial cells were observed. Ganciclovir inhibited only HCMV late antigen (LA) expression, whereas antisense oligonucleotide ISIS 2922 and peptide SN50, inhibitors of HCMV IE expression and NF-kappaB activity, respectively, inhibited both IE and LA expression. ISIS 2922 and SN50, but not ganciclovir, prevented down-modulation of TSP-1 and TSP-2. The results showed that HCMV-induced down-modulation of TSP-1 and TSP-2 in retinal glial cells is prevented by inhibition of HCMV IE expression. These findings may be relevant to pathogenesis and treatment of HCMV retinitis.

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Section: Discussionmentioning

confidence: 95%

Cytomegalovirus Infection Decreases Expression of Thrombospondin‐1 and ‐2 in Cultured Human Retinal Glial Cells: Effects of Antiviral Agents

Činátl¹,

Bittoova²,

Margraf³

et al. 2000

J INFECT DIS

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“…CMVR and HIV-related branch retinal artery occlusions have been rarely reported [8,9]. There have also been a few case reports of retinal vascular occlusion in HIV/AIDS patients without CMVR [10-15].…”

Section: Discussionmentioning

confidence: 99%

Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV

Davis

Haft²,

Hartley³

2013

J OPHTH INFLAMM INFECT

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BackgroundFive of 7 (71%) elderly immunocompetent patients with cytomegalovirus retinitis had retinal arteriolar occlusions versus 2 of 8 (25%) elderly immunocompromised patients and 1 of 19 (5%) younger HIV-infected patients. Compared to HIV-infected patients, elderly patients were more likely to have occlusive events, neovascularization or hemorrhage, and underlying vasculopathy. The purpose of this study is to report the novel finding of extensive retinal arteriolar occlusions and neovascularization in immunocompetent patients with cytomegalovirus retinitis. This is a retrospective observational cohort study of cytomegalovirus retinitis (CMVR) in a university setting. Seven patients were elderly but not immunocompromised, 8 were elderly and iatrogenically immunocompromised, and 16 were HIV-infected. All patients underwent polymerase chain reaction testing of intraocular fluid. Primary outcome measure was visual acuity. Secondary outcome measures were vascular occlusions, ischemic complications, and response to treatment.ResultsMean age was 73, 70, and 41 years for immunocompetent, immunocompromised, and HIV-infected patients, respectively. Diabetes and vascular disease were common in the elderly. Vision loss to less than 5/200 occurred in 50% of the immunocompetent elderly patients, and 17% of CMV eyes in immunocompromised and HIV patients. Occlusion of the entire retinal vasculature occurred in 4/7 (57%) of immunocompetent patients despite lack of Zone I involvement, and rubeosis occurred in three, disc neovascularization in one, and vitreous hemorrhage in two patients. Vascular occlusive events were less common in immunocompromised patients and rare in the HIV-infected.ConclusionsCMVR in non-HIV-infected elderly patients is associated with retinal arteriolar occlusions. An intact host immune response may increase damage to retinal vessels. Prompt diagnosis may avert catastrophic vision loss.

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“…The medical literature contains case reports of local thrombus in HIV-infected persons with CMV coinfection: bilateral thrombosis of the internal jugular veins [25], cerebral venous thrombosis [26], acute onset of multiple digital infarcts of both upper extremities [27], and branch retinal vein or arterial occlusion [28,29]. CMVassociated vasculitis is a well-described manifestation of CMV disease.…”

Section: Discussionmentioning

confidence: 99%

Vascular Thrombosis and Acute Cytomegalovirus Infection in Immunocompetent Patients: Report of 2 Cases and Literature Review

Abgueguen¹,

Delbos²,

Chennebault³

et al. 2003

Clinical Infectious Diseases

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Acute cytomegalovirus (CMV) infection in immunocompetent patients is common worldwide, with seroprevalence rates of 40%-100%, depending on the country, socioeconomic conditions, and the patient's age. Infection is most often asymptomatic, but acute cytomegalovirus infection is occasionally revealed by prolonged fever, cervical lymphadenitis, and arthralgia, and it is more rarely revealed by pneumonia, myocarditis, pericarditis, colitis, and hemolytic anemia. Here, we report 2 cases of acute CMV infection in nonimmunocompromised adults that were complicated by venous thrombosis with pulmonary embolism. We also review previously reported cases of vascular thrombosis and discuss the propensity of CMV to induce vascular damage with associated thrombosis.

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Branch retinal artery occlusion (BRAO) combined with branch retinal vein occlusion (BRVO) and optic disc neovascularization associated with HIV and CMV retinitis

Cited by 35 publications

References 29 publications

Cytomegalovirus Infection Decreases Expression of Thrombospondin‐1 and ‐2 in Cultured Human Retinal Glial Cells: Effects of Antiviral Agents

Cytomegalovirus Infection Decreases Expression of Thrombospondin‐1 and ‐2 in Cultured Human Retinal Glial Cells: Effects of Antiviral Agents

Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV

Vascular Thrombosis and Acute Cytomegalovirus Infection in Immunocompetent Patients: Report of 2 Cases and Literature Review

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