Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis
Purpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019....
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/11/1785 |
| _version_ | 1797467656120434688 |
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| author | Léa Fitoussi Amandine Baptiste Adam Mainguy Anne-Sophie L’Honneur Magdalena Bojanova Agnès Dechartres Flore Rozenberg Bahram Bodaghi Sara Touhami |
| author_facet | Léa Fitoussi Amandine Baptiste Adam Mainguy Anne-Sophie L’Honneur Magdalena Bojanova Agnès Dechartres Flore Rozenberg Bahram Bodaghi Sara Touhami |
| author_sort | Léa Fitoussi |
| collection | DOAJ |
| description | Purpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019. All patients received induction therapy with intravenous +/− intravitreal injections (IVI) of antivirals. Results: Forty-one eyes of 37 patients with a mean age of 56 years were included. Involved viruses were VZV (44%), CMV (37%) and HSV2 (19%). Acute retinal necrosis represented 51%, progressive outer retinal necrosis 12% and CMV retinitis 37% of eyes. Forty-six percent of patients were immunocompromised. Median BCVA was 0.7 LogMAR at baseline and 0.8 LogMAR after an average of 14.1 months. VNR bilateralized in 27% of cases after 32 months. Retinal detachment (RD) occurred in 27% of cases after a mean duration of 98 days. Factors associated with a “poor BCVA” at 1 month were: advanced age, low baseline BCVA, high vitritis grade and viral load (VL) at baseline and the “slow responder” status (i.e., VL decrease <50% after 2 weeks of treatment). Factors associated with RD were: advanced age, immunocompetence, low baseline BCVA, high vitritis grade at baseline and use of ≤5 IVIs. Conclusions: Clinical factors including advanced age, immunocompetence, low BCVA and high vitritis grade at baseline were associated with a poor prognosis. New virological factors were predictive of a poor outcome: high baseline VL and the “slow responder” status. Sequential intraocular fluid sampling might help prognosticate the outcomes of VNR. |
| first_indexed | 2024-03-09T18:56:47Z |
| format | Article |
| id | doaj.art-82ab5ffa561340798704f065e955b8ad |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T18:56:47Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-82ab5ffa561340798704f065e955b8ad2023-11-24T05:25:07ZengMDPI AGJournal of Personalized Medicine2075-44262022-10-011211178510.3390/jpm12111785Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing RetinitisLéa Fitoussi0Amandine Baptiste1Adam Mainguy2Anne-Sophie L’Honneur3Magdalena Bojanova4Agnès Dechartres5Flore Rozenberg6Bahram Bodaghi7Sara Touhami8Department of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FranceDepartment of Public Health, Centre de Pharmacoépidémiologie de l’AP-HP (Cephepi), Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FranceDepartment of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FranceDepartment of Virology, Cochin University Hospital, Université Paris Descartes, 75014 Paris, FranceDepartment of Virology, Cochin University Hospital, Université Paris Descartes, 75014 Paris, FranceDepartment of Public Health, Centre de Pharmacoépidémiologie de l’AP-HP (Cephepi), Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FranceDepartment of Virology, Cochin University Hospital, Université Paris Descartes, 75014 Paris, FranceDepartment of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FranceDepartment of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université, 75013 Paris, FrancePurpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019. All patients received induction therapy with intravenous +/− intravitreal injections (IVI) of antivirals. Results: Forty-one eyes of 37 patients with a mean age of 56 years were included. Involved viruses were VZV (44%), CMV (37%) and HSV2 (19%). Acute retinal necrosis represented 51%, progressive outer retinal necrosis 12% and CMV retinitis 37% of eyes. Forty-six percent of patients were immunocompromised. Median BCVA was 0.7 LogMAR at baseline and 0.8 LogMAR after an average of 14.1 months. VNR bilateralized in 27% of cases after 32 months. Retinal detachment (RD) occurred in 27% of cases after a mean duration of 98 days. Factors associated with a “poor BCVA” at 1 month were: advanced age, low baseline BCVA, high vitritis grade and viral load (VL) at baseline and the “slow responder” status (i.e., VL decrease <50% after 2 weeks of treatment). Factors associated with RD were: advanced age, immunocompetence, low baseline BCVA, high vitritis grade at baseline and use of ≤5 IVIs. Conclusions: Clinical factors including advanced age, immunocompetence, low BCVA and high vitritis grade at baseline were associated with a poor prognosis. New virological factors were predictive of a poor outcome: high baseline VL and the “slow responder” status. Sequential intraocular fluid sampling might help prognosticate the outcomes of VNR.https://www.mdpi.com/2075-4426/12/11/1785viral necrotizing retinitisVZVCMVHSVretinal detachmentoutcome |
| spellingShingle | Léa Fitoussi Amandine Baptiste Adam Mainguy Anne-Sophie L’Honneur Magdalena Bojanova Agnès Dechartres Flore Rozenberg Bahram Bodaghi Sara Touhami Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis Journal of Personalized Medicine viral necrotizing retinitis VZV CMV HSV retinal detachment outcome |
| title | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
| title_full | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
| title_fullStr | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
| title_full_unstemmed | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
| title_short | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
| title_sort | clinical and virological characteristics and prognostic factors in viral necrotizing retinitis |
| topic | viral necrotizing retinitis VZV CMV HSV retinal detachment outcome |
| url | https://www.mdpi.com/2075-4426/12/11/1785 |
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