Treatment of Cytomegalovirus Retinitis With Cytomegalovirus-Specific T-Lymphocyte Infusion

Abstract

Cytomegalovirus (CMV) retinitis is a blinding infection that affects immunocompromised patients who are unable to generate a T-cell response against the organism. Infusion of CMV-specific leukocytes has been shown to be effective in patients with systemic CMV infection, especially those resistant to standard therapies. We report a case of a patient with CMV viremia with retinitis in whom infusion of third-party donor derived CMV pp65-specific T-cells alone prompted resolution of CMV retinitis in this patient. This case suggests a potential role for CMV-specific leukocyte infusion in the treatment of CMV retinitis, especially in cases resistant to or refractory or antiviral therapies.

A Randomized Double-Blind Placebo-Control Pilot Study of Eplerenone for the Treatment of Central Serous Chorioretinopathy (Ecselsior)

“…Sixty-two patients were excluded because of no history of CMV retinitis (11), history of CMV retinitis that was no longer active (33), active CMV retinitis not involving the macula (11), macular CMV retinitis with no available OCT imaging (5), or with media opacity limiting imaging quality (2). Sixty-two patients were excluded because of no history of CMV retinitis (11), history of CMV retinitis that was no longer active (33), active CMV retinitis not involving the macula (11), macular CMV retinitis with no available OCT imaging (5), or with media opacity limiting imaging quality (2).…”

“…Treatment modalities used during the study period (defined as from the time of diagnosis of macular CMV retinitis until the last available follow-up with SD-OCT imaging available) were recorded, including systemic antiviral therapy, intravitreal antiviral therapy, CMVspecific T-lymphocyte intravenous infusions as previously described, 11 and/or surgery. The following ophthalmologic examination details were recorded: best-corrected visual acuity (VA), presence or absence of vitreous detachment, vitreous cell, vitreoretinal interface abnormalities, epiretinal membrane (ERM), cystoid macular edema, and foveal involvement of retinitis.…”

Clinical Presentation and Disease Course of Usher Syndrome Because of Mutations in Myo7a or Ush2a

“…Sixty-two patients were excluded because of no history of CMV retinitis (11), history of CMV retinitis that was no longer active (33), active CMV retinitis not involving the macula (11), macular CMV retinitis with no available OCT imaging (5), or with media opacity limiting imaging quality (2).…”

“…The following ophthalmologic examination details were recorded: best-corrected visual acuity (VA), presence or absence of vitreous detachment, vitreous cell, vitreoretinal interface abnormalities, epiretinal membrane (ERM), cystoid macular edema, and foveal involvement of retinitis. Treatment modalities used during the study period (defined as from the time of diagnosis of macular CMV retinitis until the last available follow-up with SD-OCT imaging available) were recorded, including systemic antiviral therapy, intravitreal antiviral therapy, CMVspecific T-lymphocyte intravenous infusions as previously described, 11 and/or surgery.…”

Cytomegalovirus Retinitis in the Post-cART Era

“…CMV-CTLs administered for systemic CMV infection after bone-marrow transplant have been associated with significant expansion of T-cell lines, decrease in CMV viral titers and control of systemic CMV infection [120–122]. We previously reported a single case of long-term successful treatment of multi-drug-resistant CMVR with CMV-CTLs, without concurrent systemic or intravitreal antiviral therapy [123]. Further studies are necessary to determine the long-term efficacy and safety of these CMV-specific T-cell infusions, if any, for patients with CMVR.…”