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Clinical features of cytomegalovirus retinitis after solid organ transplantation versus hematopoietic stem cell transplantation

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate and compare the clinical features of cytomegalovirus (CMV) retinitis after solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) and to determine the poor prognostic factors.

Methods

Patients consulted to the ophthalmology department for CMV viremia after transplantation between March 2008 and February 2018 and followed for more than 6 months were analyzed. Medical records regarding demographic, serologic, and ocular characteristics were compared between the SOT and HSCT groups. Factors associated with poor visual outcomes were determined with logistic regression.

Results

CMV retinitis developed in 11.3% of patients with CMV viremia following transplantation. In the SOT group (25 eyes/18 patients) and the HSCT group (33 eyes/21 patients), CMV retinitis occurred at 5.8 months and 3.7 months post-transplantation, respectively. Mortality was significantly higher in the HSCT group (52.4% vs. 5.6%, P < 0.001). During the mean 11.7 months of follow-up, visual acuity tended to be aggravated (P = 0.087) despite antiviral treatment, which was especially notable in the SOT group (P = 0.028). Six eyes (10.3%) underwent vitrectomy due to retinal detachment, most of which (5 eyes) were in the SOT group. Multivariate logistic regression analysis showed that the presence of concurrent CMV disease (OR = 14.11, P = 0.009) and foveal involvement (OR = 114.85, P = 0.001) were poor prognostic factors.

Conclusion

Clinical manifestations of CMV retinitis differed between the HSCT and SOT group. Concurrent CMV diseases and foveal involvement were associated with poor visual outcomes in CMV retinitis following transplantation.

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Funding

This study was supported by a grant from the Ministry of Science and ICT (Information and Communication Technology) (NRF-2019R1F1A1063124) and Asan Institute for Life Sciences (2011-0660), Asan Medical Center, Seoul, South Korea (NRF-2019R1F1A1063124).

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Authors and Affiliations

  1. Department of Retinal Service, Hangil Eye Hospital, Incheon, South Korea

    Gisung Son

  2. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Joo Yong Lee, June-Gone Kim & Yoon Jeon Kim

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  1. Gisung Son
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  2. Joo Yong Lee
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  3. June-Gone Kim
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Correspondence to Yoon Jeon Kim.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the (place name of the institution and/or national research committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The informed consent was waived under the approval of the Institutional Review Board of Asan Medical Center (2018-0815).

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Son, G., Lee, J.Y., Kim, JG. et al. Clinical features of cytomegalovirus retinitis after solid organ transplantation versus hematopoietic stem cell transplantation. Graefes Arch Clin Exp Ophthalmol 259, 585–591 (2021). https://doi.org/10.1007/s00417-020-04871-w

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  • DOI: https://doi.org/10.1007/s00417-020-04871-w

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