Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty

AIM: To investigate corneal graft survival rate and endothelial cell density (ECD) loss after keratoplasty in cytomegalovirus (CMV) positive patients. METHODS: This was a retrospective cohort study. We analyzed the clinical data of patients who underwent viral DNA detection in aqueous humor/corneal...

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Main Authors: Yun-Xiao Zang, Rong-Mei Peng, Han-Zhi Ben, Jing-Hao Qu, Ge-Ge Xiao, Li-Xue Shuai, Pei Zhang, Li-Na Feng, Jing Hong
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2023-01-01
Series:International Journal of Ophthalmology
Subjects:
Online Access:http://ies.ijo.cn/en_publish/2023/1/20230108.pdf
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author Yun-Xiao Zang
Rong-Mei Peng
Han-Zhi Ben
Jing-Hao Qu
Ge-Ge Xiao
Li-Xue Shuai
Pei Zhang
Li-Na Feng
Jing Hong
author_facet Yun-Xiao Zang
Rong-Mei Peng
Han-Zhi Ben
Jing-Hao Qu
Ge-Ge Xiao
Li-Xue Shuai
Pei Zhang
Li-Na Feng
Jing Hong
author_sort Yun-Xiao Zang
collection DOAJ
description AIM: To investigate corneal graft survival rate and endothelial cell density (ECD) loss after keratoplasty in cytomegalovirus (CMV) positive patients. METHODS: This was a retrospective cohort study. We analyzed the clinical data of patients who underwent viral DNA detection in aqueous humor/corneal tissue collected during keratoplasty from March 2015 to December 2018 at the Peking University Third Hospital, Beijing, China. To further evaluate the effect of CMV on graft survival rate and ECD loss, patients were divided into three groups: 1) CMV DNA positive (CMV+) group; 2) viral DNA negative (virus-) group, comprising virus- group eyes pairwise matched to eyes in the CMV+ group according to ocular comorbidities; 3) control group, comprising virus- group eyes without ocular comorbidities. The follow-up indicators including graft survival rate, ECD, ECD loss, and central corneal thickness (CCT), were analyzed by Tukey honestly significant difference (HSD) test. RESULTS: Each group included 29 cases. The graft survival rate in CMV+ group were lowest among the three groups (P=0.000). No significant difference in donor graft ECD was found among three groups (P=0.54). ECD in the CMV+ group was lower than the virus- group at 12 (P=0.009), and 24mo (P=0.002) after keratoplasties. Furthermore, ECD loss was higher in the CMV+ group than in the virus- group in the middle stage (6-12mo) post-keratoplasty (P=0.017), and significantly higher in the early stage (0-6mo) in the virus- group than in the control group (P=0.000). CONCLUSION: CMV reduces the graft survival rate and exerts persistent detrimental effects on the ECD after keratoplasty. The graft ECD loss associate with CMV infection mainly occurrs in the middle stage (6-12mo postoperatively), while ocular comorbidities mainly affects ECD in the early stage (0-6mo postoperatively).
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spelling doaj.art-21b1af531aed495792ba28fed41a3eb92022-12-28T07:41:47ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982023-01-01161535910.18240/ijo.2023.01.0820230108Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplastyYun-Xiao Zang0Rong-Mei Peng1Han-Zhi Ben2Jing-Hao Qu3Ge-Ge Xiao4Li-Xue Shuai5Pei Zhang6Li-Na Feng7Jing Hong8Jing Hong. Peking University Third Hospital, Peking University Eye Center, No.49 Garden North Road, Haidian, Beijing 100191, China. hongjing196401@163.comDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, ChinaAIM: To investigate corneal graft survival rate and endothelial cell density (ECD) loss after keratoplasty in cytomegalovirus (CMV) positive patients. METHODS: This was a retrospective cohort study. We analyzed the clinical data of patients who underwent viral DNA detection in aqueous humor/corneal tissue collected during keratoplasty from March 2015 to December 2018 at the Peking University Third Hospital, Beijing, China. To further evaluate the effect of CMV on graft survival rate and ECD loss, patients were divided into three groups: 1) CMV DNA positive (CMV+) group; 2) viral DNA negative (virus-) group, comprising virus- group eyes pairwise matched to eyes in the CMV+ group according to ocular comorbidities; 3) control group, comprising virus- group eyes without ocular comorbidities. The follow-up indicators including graft survival rate, ECD, ECD loss, and central corneal thickness (CCT), were analyzed by Tukey honestly significant difference (HSD) test. RESULTS: Each group included 29 cases. The graft survival rate in CMV+ group were lowest among the three groups (P=0.000). No significant difference in donor graft ECD was found among three groups (P=0.54). ECD in the CMV+ group was lower than the virus- group at 12 (P=0.009), and 24mo (P=0.002) after keratoplasties. Furthermore, ECD loss was higher in the CMV+ group than in the virus- group in the middle stage (6-12mo) post-keratoplasty (P=0.017), and significantly higher in the early stage (0-6mo) in the virus- group than in the control group (P=0.000). CONCLUSION: CMV reduces the graft survival rate and exerts persistent detrimental effects on the ECD after keratoplasty. The graft ECD loss associate with CMV infection mainly occurrs in the middle stage (6-12mo postoperatively), while ocular comorbidities mainly affects ECD in the early stage (0-6mo postoperatively).http://ies.ijo.cn/en_publish/2023/1/20230108.pdfkeratoplastycytomegalovirusocular comorbiditiesendothelial cell densitycentral corneal thickness
spellingShingle Yun-Xiao Zang
Rong-Mei Peng
Han-Zhi Ben
Jing-Hao Qu
Ge-Ge Xiao
Li-Xue Shuai
Pei Zhang
Li-Na Feng
Jing Hong
Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
International Journal of Ophthalmology
keratoplasty
cytomegalovirus
ocular comorbidities
endothelial cell density
central corneal thickness
title Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
title_full Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
title_fullStr Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
title_full_unstemmed Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
title_short Destructive effects on endothelial cells of grafts in cytomegalovirus DNA-positive patients after keratoplasty
title_sort destructive effects on endothelial cells of grafts in cytomegalovirus dna positive patients after keratoplasty
topic keratoplasty
cytomegalovirus
ocular comorbidities
endothelial cell density
central corneal thickness
url http://ies.ijo.cn/en_publish/2023/1/20230108.pdf
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