Multiple intravitreal injections of ganciclovir for cytomegalovirus retinitis after stem-cell transplantation

Miao, Heng; Tao, Yong; Jiang, Yanrong; Li, Xiaoxin

doi:10.1007/s00417-013-2368-6

Cited by 28 publications

(31 citation statements)

References 12 publications

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“…4 Topical anesthesia was applied before the injection, and the patients were draped completely as for any intraocular surgery. A lid speculum was inserted, and more than 50-100 mL of aqueous humor was obtained by paracentisis using a sharp 27-gauge needle.…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3][4][5] In China, the prevalence of CMVR in hospitalized AIDS patients is 7.6%. 6 Once CMVR is diagnosed, anti-cytomegalovirus (CMV) therapy should be administered.…”

Section: Introductionmentioning

confidence: 99%

“…7 Multiple intravitreal injections of ganciclovir or foscarnet appeared to be well tolerated and improvement of the retinitis was observed, either in AIDS patients 8,9 or in non-AIDS patients. 4,10 Previous studies implied that inflammation cytokines, including interleukin (IL)-2, [11][12][13][14] IL-4, 15 and IL-17, 16 may be involved in the development of CMVR by influencing the patient's susceptibility to it. However, to our knowledge, these previous studies about the relationship between inflammation cytokines and CMVR are generally based on animal or cell studies.…”

Section: Introductionmentioning

confidence: 99%

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Continued Decline of Aqueous Interleukin-8 After Multiple Intravitreal Injections of Ganciclovir for Cytomegalovirus Retinitis

Wang

Tian²,

Tao³

et al. 2014

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To evaluate the relationship between aqueous inflammation cytokines and cytomegalovirus (CMV) particles in patients with cytomegalovirus retinitis (CMVR), and evaluate the changes in aqueous inflammation cytokines during multiple intravitreal injections of antiviral drugs for CMVR. Methods: There were 10 patients (12 eyes; 16 courses of treatment per eye) who underwent continued intravitreal ganciclovir or foscarnet for treatment of CMVR. Before each intravitreal injection, 50-100 mL of aqueous humor was removed and sent to the laboratory to examine the concentration of the CMV DNA load by using polymerase chain reaction and to examine the concentration of interleukin (IL)-1b, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-a, and IL-12p70 using a cytometric bead array. Results: A Kendall correlation test showed that the concentration of the CMV DNA load in the aqueous humor was significantly associated with the aqueous level of IL-6 (P < 0.001, r = 0.327) and IL-8 (P < 0.001, r = 0.381), but not significantly associated with IL-1b, IL-10, IL-12p70, and TNF-a. The boxplots showed that the concentration of the aqueous CMV DNA load, IL-8 and IL-10 continuously declined after multiple intravitreal injections of antiviral drugs, and the decline trend of IL-8 was most remarkable. IL-1b, IL-10, TNF-a, and IL12p70 were negative in some of the aqueous levels of CMVR patients throughout the course of treatment (25.0%-62.5%). Conclusions: Our study showed that IL-8 was significantly associated with the aqueous level of CMV copies and continuously declined during a course of treatment that involved multiple intravitreal injections of antiviral drugs. IL-8 may be considered a good quantitative laboratory indicator of the recovery of CMVR.

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Section: Methodsmentioning

confidence: 99%

“…[1][2][3][4][5] In China, the prevalence of CMVR in hospitalized AIDS patients is 7.6%. 6 Once CMVR is diagnosed, anti-cytomegalovirus (CMV) therapy should be administered.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Continued Decline of Aqueous Interleukin-8 After Multiple Intravitreal Injections of Ganciclovir for Cytomegalovirus Retinitis

Wang

Tian²,

Tao³

et al. 2014

Journal of Ocular Pharmacology and Therapeutics

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“…The risk of CMVR in clear immunocompromise, and primarily after hematopoietic stem cell transplantation (HSCT), shows a trend of increase during the past decade (Miao et al 2013) (see Table S1). Jeon et al (2012) evaluated risk factors for CMVR in a cohort of patients with CMV viremia following HSCT.…”

Section: Cmvr In Non-hiv-related Systemic Immunosuppressionmentioning

confidence: 99%

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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“…In addition, there were some risk factors for secondary CMV retinitis such as transplantation, the use of high-dose corticosteroids, and graft-versus-host disease. [14–16] …”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus retinitis in a patient with secondary acute lymphosarcoma leukemia undergoing allogeneic hematopoietic stem-cell transplantation

Zhao

Liu²,

Xu³

2017

Medicine

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Rationale:Cytomegalovirus (CMV) retinitis is a common opportunistic infection in immunocompromised patients, which may lead to blindness. CMV retinitis is not an uncommon infectious disease in patients with immune regulatory abnormalities, for example, human immunodeficiency virus (HIV) patients. However, CMV retinitis in a patient with acute lymphosarcoma leukemia (ALL) undergoing allogeneic hematopoietic stem-cell transplantation (HSCT) phase is very rare.Patient concerns:A case of CMV retinitis in a patient receiving immunosuppressive therapy as a part of ALL allogeneic HSCT is described including the pathogenesis, clinical signs, and therapy.Diagnoses:CMV retinitis.Interventions:Ganciclovir intravitreal injection at weekly intervals for 4 weeks.Outcomes:Patient's vision had improved and the load of CMV deoxyribonucleic acid (DNA) in the aqueous humor declined. The CMV retinitis and perivascular of retina infiltration regressed.Lessons:We propose that the concentration of CMV DNA load in the aqueous humor could be useful in making the diagnosis and in selecting the optimal treatment in this kind of CMV retinitis.

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Multiple intravitreal injections of ganciclovir for cytomegalovirus retinitis after stem-cell transplantation

Abstract: Multiple IVG seemed to be beneficial for patients with CMV retinitis after stem-cell transplantation, in reducing CMV levels in aqueous humor. Further study to optimize the dose of ganciclovir is needed in order to achieve better treatment outcomes.

Cited by 28 publications

References 12 publications

Continued Decline of Aqueous Interleukin-8 After Multiple Intravitreal Injections of Ganciclovir for Cytomegalovirus Retinitis

Continued Decline of Aqueous Interleukin-8 After Multiple Intravitreal Injections of Ganciclovir for Cytomegalovirus Retinitis

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

Cytomegalovirus retinitis in a patient with secondary acute lymphosarcoma leukemia undergoing allogeneic hematopoietic stem-cell transplantation

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