Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation.
<h4>Purpose</h4>To identify the visual prognostic factors in patients with cytomegalovirus (CMV) retinitis after hematopoietic stem cell transplantation (HSCT).<h4>Methods</h4>This retrospective cohort study included 4241 patients who underwent HSCT from April 1, 2010 to Marc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0238257 |
| _version_ | 1818587143978614784 |
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| author | Joo Young Kim Seo-Yeon Hong Woo Kyung Park Rae Young Kim Mirinae Kim Young-Gun Park Hee-Je Kim Seok Lee Dong Gun Lee Young-Hoon Park |
| author_facet | Joo Young Kim Seo-Yeon Hong Woo Kyung Park Rae Young Kim Mirinae Kim Young-Gun Park Hee-Je Kim Seok Lee Dong Gun Lee Young-Hoon Park |
| author_sort | Joo Young Kim |
| collection | DOAJ |
| description | <h4>Purpose</h4>To identify the visual prognostic factors in patients with cytomegalovirus (CMV) retinitis after hematopoietic stem cell transplantation (HSCT).<h4>Methods</h4>This retrospective cohort study included 4241 patients who underwent HSCT from April 1, 2010 to March 31, 2019 at Seoul St. Mary's Hospital. Of them, 1063 patients presented CMV viremia, and 67 patients (93 eyes) were diagnosed with CMV retinitis. We enrolled 66 patients (91 eyes). The main outcomes included the initial best-corrected visual acuity (BCVA), BCVA at the diagnosis of retinitis and last visit, involved retinal zone, peak CMV DNA levels in the peripheral blood and aqueous humor, time between HSCT and the diagnosis of retinitis, time between the diagnosis of viremia and retinitis, complications, recurrence, survival, and so on.<h4>Results</h4>The mean BCVA (logarithm of the minimum angle of resolution) values before HSCT, at the time of retinitis diagnosis, and at the last visit were 0.041 ± 0.076, 0.262 ± 0.529, and 0.309 ± 0.547, respectively. Multiple regression analysis revealed that the involved zone (P = 0.001), time between HSCT and retinitis diagnosis (P = 0.019), and survival status (P = 0.001) were associated with the final visual acuity.<h4>Conclusions</h4>The final visual prognosis was worse in patients with greater invasion of the central retinal zone, those with a longer interval between HSCT and the diagnosis of retinitis, and those who died. Prompt diagnosis of CMV retinitis through periodic fundus examinations of patients with CMV viremia can prevent severe vision loss. Once CMV viremia is confirmed, we recommend fundus examinations to be immediately performed and repeated every 2 weeks for at least 2 months, even if the CMV DNA titer in the peripheral blood becomes negative. |
| first_indexed | 2024-12-16T09:04:11Z |
| format | Article |
| id | doaj.art-e0c0779b09d840d082edd9b79fac5e89 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T09:04:11Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e0c0779b09d840d082edd9b79fac5e892022-12-21T22:37:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159e023825710.1371/journal.pone.0238257Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation.Joo Young KimSeo-Yeon HongWoo Kyung ParkRae Young KimMirinae KimYoung-Gun ParkHee-Je KimSeok LeeDong Gun LeeYoung-Hoon Park<h4>Purpose</h4>To identify the visual prognostic factors in patients with cytomegalovirus (CMV) retinitis after hematopoietic stem cell transplantation (HSCT).<h4>Methods</h4>This retrospective cohort study included 4241 patients who underwent HSCT from April 1, 2010 to March 31, 2019 at Seoul St. Mary's Hospital. Of them, 1063 patients presented CMV viremia, and 67 patients (93 eyes) were diagnosed with CMV retinitis. We enrolled 66 patients (91 eyes). The main outcomes included the initial best-corrected visual acuity (BCVA), BCVA at the diagnosis of retinitis and last visit, involved retinal zone, peak CMV DNA levels in the peripheral blood and aqueous humor, time between HSCT and the diagnosis of retinitis, time between the diagnosis of viremia and retinitis, complications, recurrence, survival, and so on.<h4>Results</h4>The mean BCVA (logarithm of the minimum angle of resolution) values before HSCT, at the time of retinitis diagnosis, and at the last visit were 0.041 ± 0.076, 0.262 ± 0.529, and 0.309 ± 0.547, respectively. Multiple regression analysis revealed that the involved zone (P = 0.001), time between HSCT and retinitis diagnosis (P = 0.019), and survival status (P = 0.001) were associated with the final visual acuity.<h4>Conclusions</h4>The final visual prognosis was worse in patients with greater invasion of the central retinal zone, those with a longer interval between HSCT and the diagnosis of retinitis, and those who died. Prompt diagnosis of CMV retinitis through periodic fundus examinations of patients with CMV viremia can prevent severe vision loss. Once CMV viremia is confirmed, we recommend fundus examinations to be immediately performed and repeated every 2 weeks for at least 2 months, even if the CMV DNA titer in the peripheral blood becomes negative.https://doi.org/10.1371/journal.pone.0238257 |
| spellingShingle | Joo Young Kim Seo-Yeon Hong Woo Kyung Park Rae Young Kim Mirinae Kim Young-Gun Park Hee-Je Kim Seok Lee Dong Gun Lee Young-Hoon Park Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. PLoS ONE |
| title | Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. |
| title_full | Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. |
| title_fullStr | Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. |
| title_full_unstemmed | Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. |
| title_short | Prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation. |
| title_sort | prognostic factors of cytomegalovirus retinitis after hematopoietic stem cell transplantation |
| url | https://doi.org/10.1371/journal.pone.0238257 |
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