关键词: 巨细胞病毒性视网膜炎, 造血干细胞移植

Abstract:

 Objective To observe the clinical characteristics of cytomegalovirus retinitis (CMVR) after allogeneic bone marrow hematopoietic stem cell transplantation (Allo-HSCT) in children. Design Retrospective case series. Participants 167 cases (334 eyes) of Allo-HSCT were included in the study from June 2015 to May 2018 in Beijing Jingdu Children’s Hospital. Methods Retrospective analysis of systemic characteristics, ocular clinical features and follow-up of children with CMVR after HSCT were performed. Main Outcome Measures The composition ratio of CMVR, visual acuity, fundus lesions. Results 12 cases (7.18%) of CMVR developed in 167 consecutive Allo-HSCT recipients (age range, 1-17 years). Average age of CMVR children was 9.8 ± 3.9 years old. There were six males CMVR children (50%). The primary disease of 12 children with CMVR was hemophagocytic syndrome (7 cases, 58.3%). CMVR was diagnosed at a median of 161 days (range, 63 to 295) after HSCT. The CMV-DNA levels of aqueous humor were not significantly associated with the peak CMV-DNA levels of blood (r=-0.188, P=0.49). The mean visual acuity of CMVR children on first visit was 0.9 ±1.3 logMAR. The mean intraocular pressure o of CMVR children was 22.0±3.0 mmHg. There were 11 eyes (45.8%) with active inflammation in anterior segment, 10 eyes (41.7%) with cataract, and 8 eyes (33.3%) with involved macular lesions. Conclusion In pediatric Allo-HSCT recipients, hemophagocytic syndrome was the main primary disease of CMVR, and CMVR incidence in children is higher than in adults. An early active ophthalmic screening approach is required for pediatric Allo-HSCT recipients with CMV viremia. Early intervention treatment for CMVR children can save their vision. (Ophthalmol CHN, 2019, 28: 260-264)

Key words: cytomegalovirus retinitis, hematopoietic stem cell transplantation