Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV 英文参考文献.docVIP

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Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV 英文参考文献.doc

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Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV 英文参考文献

Davisetal.JournalofOphthalmicInflammationandInfection2013,3:17 /content/3/1/17 ORIGINAL RESEARCH OpenAccess Retinalarteriolarocclusionsdueto cytomegalovirusretinitisinelderlypatients withoutHIV JanetLDavis*,PaymanHaftandKristenHartley Abstract Background:Fiveof7(71%)elderlyimmunocompetentpatientswithcytomegalovirusretinitishadretinalarteriolar occlusionsversus2of8(25%)elderlyimmunocompromisedpatientsand1of19(5%)youngerHIV-infected patients.ComparedtoHIV-infectedpatients,elderlypatientsweremorelikelytohaveocclusiveevents, neovascularizationorhemorrhage,andunderlyingvasculopathy.Thepurposeofthisstudyistoreportthenovel findingofextensiveretinalarteriolarocclusionsandneovascularizationinimmunocompetentpatientswith cytomegalovirusretinitis.Thisisaretrospectiveobservationalcohortstudyofcytomegalovirusretinitis(CMVR)in auniversitysetting.Sevenpatientswereelderlybutnotimmunocompromised,8wereelderlyandiatrogenically immunocompromised,and16wereHIV-infected.Allpatientsunderwentpolymerasechainreactiontestingof intraocularfluid.Primaryoutcomemeasurewasvisualacuity.Secondaryoutcomemeasureswerevascular occlusions,ischemiccomplications,andresponsetotreatment. Results:Meanagewas73,70,and41yearsforimmunocompetent,immunocompromised,andHIV-infectedpatients, respectively.Diabetesandvasculardiseasewerecommonintheelderly.Visionlosstolessthan5/200occurredin50% oftheimmunocompetentelderlypatients,and17%ofCMVeyesinimmunocompromisedandHIVpatients.Occlusion oftheentireretinalvasculatureoccurredin4/7(57%)ofimmunocompetentpatientsdespitelackofZoneI involvement,andrubeosisoccurredinthree,discneovascularizationinone,andvitreoushemorrhageintwopatients. VascularocclusiveeventswerelesscommoninimmunocompromisedpatientsandrareintheHIV-infected. Conclusions:CMVRinnon-HIV-infectedelderlypatientsisassociatedwithretinalarteriolarocclusions.Anintacthost immuneresponsemayincreasedamagetoretinalvessels.Promptdiagnosismayavertcatastrophicvisionloss. Keywords:Cytomegalovirusretinitis,Immunocompetent,Immunoco