Spectral domain optical coherence tomography and fundus autofluorescence findings in cytomegalovirus retinitis in HIV-infected patients

Yashiro, Shigeko; Nishijima, Takeshi; Yamamoto, Yuuka; Sekine, Yumi; Yoshida-Hata, Natsuyo; Iida, Tomohiro; Oka, Shinichi

doi:10.1007/s10384-018-0574-9

Cited by 13 publications

(13 citation statements)

References 33 publications

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“…OCT characteristics of patients in the CMVR group: In the present study, the thickness of various macular regions in the CMVR group generally increased, and the reflection of the entorretina increased. [10] This is consistent with the study results reported by Japanese scholar Yashiro et al, [11] but is contradictory to the study results reported by Pathai [12] and Plummer. [13] Plummer et al used a Heidelberg retina tomograph to measure the thickness of the nerve fiber layer in 38 HIV positive patients with or without CMVR and 24 HIV negative controls, and found that the thickness of the nerve fiber layer of HIV positive patients was smaller than that of the controls, regardless of CMVR.…”

Section: Discussionsupporting

confidence: 81%

A comparative study on retinal thickness of the macular region among AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients, and cytomegalovirus retinitis patients

et al. 2019

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The present study aims to measure the retinal thickness of the macular region of AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients and cytomegalovirus retinitis (CMVR) patients by optical coherence tomography, and generalize the characteristics of retinal thickness of these 3 groups of patients. In this retrospective case series, the study object comprised of 111 AIDS patients who received diagnosis and treatment in the Ophthalmology Department of Beijing Youan Hospital. There are 33 patients in the AIDS normal ocular fundus group, 47 patients in the HIV-related microvascular retinopathy group, and 31 patients in the CMVR group. The retinal thickness of the macular region of these above patients was measured. The main indicators were retinal thickness of 9 macular partitions, best corrected visual acuity, CD4+ T lymphocyte count, and the start of highly active antiretroviral therapy. In the CMVR group, except for the nasal-outer and temporal-outer sectors, the thickness of the affected eye of the rest of the regions was greater than that of healthy eye ( P < .05). Furthermore, there was a difference in thickness of the superior-outer and inferior-outer sectors between the AIDS normal ocular fundus group and HIV-related microvascular retinopathy group. The difference in thickness of the superior-inner sector between patients in the AIDS normal ocular fundus group and CMVR group was not statistically significant, while the difference in thickness of the rest of the regions was statistically significant. The difference in thickness of various regions between patients in the HIV-related microvascular retinopathy group and CMVR group was statistically significant. The retinal thickness of patients in the CMVR group generally increased, the retinal thickness of superior-outer and inferior-outer sections of patients in the HIV-related microvascular retinopathy group increased, when compared to the AIDS normal ocular fundus group. These optical coherence tomography (OCT) examination results present its own characteristics in different eye diseases in AIDS patients, and different stages of eye disease.

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Section: Discussionsupporting

confidence: 81%

A comparative study on retinal thickness of the macular region among AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients, and cytomegalovirus retinitis patients

et al. 2019

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“…It is distinct in appearance from the early stage CMVR or MVR. In the optical coherence tomography, these white granular lesions showed concavity of the retinal nerve fber layer (RNFL) toward the retinal pigment epithelium and destruction of all retinal layers vertically; while the cotton wool spot showed elevation of the RNFL and no destruction of the retinal structure [7] . We divided it into an independent group and compared it with early stage CMVR group, posterior MVR group and peripheral MVR group in age and CD4+T lymphocyte level.…”

Section: Discussionmentioning

confidence: 97%

“…CMVR was defined through fundus examination showing local or quadrantal retinal necrosis: cheese ketchup necrosis, granular appearance or frosted branch retinal angiitis. CMVR was divided into two categories as follows: (1) initial stage (when the focus is less than one disc diameter and observation was approximately less than one week after onset), (2) early stage (when the initial therapeutic dose of anti-CMV agents is used and the observation was approximately less than 2 to 4 weeks after onset) [7] . For HIV-related MVR, a participant was defined as having posterior or peripheral cotton wool spots, microaneurysms, telangiectasia, or retinal hemorrhages.…”

Section: Introductionmentioning

confidence: 99%

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Chen

Guo

et al. 2019

Preprint

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Background: To observe the retinal lesions in HIV/AIDS patients and to evaluate the consistency of non-mydriatic ultra-wide-field (UWF) retinal imaging and mydriatic slit lamp biomicroscope with Superfield lens. Methods: 193 eyes of 98 consecutive HIV/AIDS patients were enrolled. The retinal lesions in each patients were observed through UWF fundus imaging and slit lamp biomicroscopic with Superfield lens whose consistency was analyzed. Results: 100 eyes (51.8%） had fundus lesions, 20 eyes (20%) presented posterior microvascular retinopathy (MVR), 19 eyes (19%) presented peripheral MVR, 15 eyes (15%) presented early stage cytomegalovirus retinitis (CMVR), 6 eyes showed initial stage CMVR, and 51 eyes showed other changes (papilledema, etc.). The consistency of two methods was moderate in detecting the isolated peripheral lesions (Kappa = 0.445) or HIV-related MVR (Kappa = 0.513), and high in inspecting the posterior/posterior involved lesions (Kappa = 0.831) or CMVR (Kappa = 1.0). The detection rate of UWF retinal imaging and slit lamp biomicroscopic were 15.5%（30/193）and 17.6%（34/193）(P=0.557＞0.05) for HIV-related MVR, 7.8% (15/193) (P=1.000＞0.05) for CMVR, 37.3% (72/193) and 33.7% (65/193) (P=0.118＞0.05) for posterior/posterior involved lesions, 8.8% (17/193) and 17.6% (34/193) (P=0.001＜0.05) for isolated peripheral lesions , respectively. Conclusions: The HIV-related MVR can be posterior or peripheral. Various fundus changes appear in HIV/AIDS patients, not only MVR or CMVR. The non-mydriatic UWF fundus imaging system and mydriatic slit lamp biomicroscope exhibited good consistency and nondiscriminatory detection rate for CMVR, HIV-related MVR and posterior lesions, but not for isolated peripheral lesions.

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“…The selective EZ disruption may represent early CMV infection via this route and could be recovered if the treatment was initiated promptly before viral induced photoreceptor apoptosis 18 . Some cases with persistent loss of outer layer with preserved inner retinal layers were described 19 . Moreover, evidence of delineate line of hyperautofluorescence along the active leading edge of the retinitis also suggested early involvement at the RPE/photoreceptor level 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Extralesional microvascular and structural macular abnormalities in cytomegalovirus retinitis

Wongchaisuwat

Khongpipatchaisiri

Boonsopon

et al. 2020

Sci Rep

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To evaluate extralesional microvascular and structural changes of the macula using optical coherence tomography angiography (OCTA) and structural OCT in cytomegalovirus retinitis (CMVR). An observational study of CMVR patients were performed. Complete ophthalmic examination, serial color fundus photography, structural OCT and OCTA were performed at baseline and follow-up visits for up to 12 months. The structural OCT was analyzed to evaluate macular areas within, bordering and beyond the CMVR lesions. Extralesional retinal capillary plexus of the macula were evaluated by OCT angiography and compared with the unaffected fellow eyes. Thirteen eyes from 13 patients were enrolled. At baseline, macular areas without CMVR lesions showed decreased vessel density (VD) of both the superficial (P = 0.0002) and deep (P < 0.0001) retinal capillary plexus in eyes with CMVR as compared with the corresponding macular areas of the unaffected fellow eyes. The decrease of VD persisted through the follow-up period for up to 12 months after adjusting for degree of vitreous haze. Structural macular OCT characteristics at the borders and beyond the lesions included intraretinal hyperreflective dots, cystoid macular edema, subretinal fluid and selective ellipsoid zone (EZ) loss. The selective EZ loss found in 6 of 12 eyes showed recovery in 4 eyes after receiving anti-viral treatment. In CMVR eyes, there were microvascular and microstructural abnormalities in the macular area without clinically visible CMVR lesions. Our results provided interesting insights into CMV infection of the retina.

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Spectral domain optical coherence tomography and fundus autofluorescence findings in cytomegalovirus retinitis in HIV-infected patients

Cited by 13 publications

References 33 publications

A comparative study on retinal thickness of the macular region among AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients, and cytomegalovirus retinitis patients

A comparative study on retinal thickness of the macular region among AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients, and cytomegalovirus retinitis patients

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Extralesional microvascular and structural macular abnormalities in cytomegalovirus retinitis

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