眼液聚合酶链式反应同时多阳性的传染性葡萄膜炎的治疗结果

IF 2.3 2区医学 Q2 OPHTHALMOLOGY

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2024-05-01 Epub Date: 2024-04-18 DOI:10.1097/IAE.0000000000004037

Viet Q Chau, John W Hinkle, Chris Y Wu, Parastou Pakravan, Vincent Volante, Jesse D Sengillo, Patrick C Staropoli, Darlene Miller, Nicolas A Yannuzzi, Thomas A Albini

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引用次数: 0

摘要

目的：评估通过眼液采样检测到的与多种病原体相关的传染性泛葡萄膜炎的特征：2001-2021年期间，单中心、回顾性、连续病例系列，对单份样本中出现>1个阳性结果的患者进行眼液/玻璃体聚合酶链反应（PCR）检测：在 1,588 份 PCR 样本中，28 份（1.76%）对两种病原体呈阳性。最常见的病原体是巨细胞病毒（CMV）（16 例，占 57.1%）和 Epstein-Barr 病毒（EBV）（13 例，占 46.4%），其次是水痘带状疱疹病毒（8 例，占 28.6%）、弓形虫（6 例，占 21.4%）、单纯疱疹病毒-2（6 例，占 21.4%）、单纯疱疹病毒-1（6 例，占 21.4%）和弓形虫（1 例，占 3.6%）。初始和最终平均视力（VA）（logMAR）分别为 1.3 ± 0.9（斯奈伦视力表 ∼ 20/400）和 1.3 ± 1.1（斯奈伦视力表 ∼ 20/400）。CMV阳性眼（16只，占61.5%）的最终平均视力为0.94 ± 1.1（Snellen∼20/175），而CMV阴性眼（10只，占38%）的最终视力为1.82 ± 1.0（Snellen∼20/1320）（P结论：CMV或EBV是一种常见的致盲病毒：在多重 PCR 阳性样本中，CMV 或 EBV 是常见的独特病原体。大多数合并感染的患者都有免疫抑制，视网膜脱离率高，最终视力较差。与 CMV 阴性眼相比，CMV 阳性眼的视觉效果更好。

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OUTCOMES OF INFECTIOUS PANUVEITIS ASSOCIATED WITH SIMULTANEOUS MULTI-POSITIVE OCULAR FLUID POLYMERASE CHAIN REACTION.

Purpose: To evaluate features of infectious panuveitis associated with multiple pathogens detected by ocular fluid sampling.

Methods: Single-center, retrospective, consecutive case series of patients with aqueous/vitreous polymerase chain reaction testing with >1 positive result in a single sample from 2001 to 2021.

Results: Of 1,588 polymerase chain reaction samples, 28 (1.76%) were positive for two pathogens. Most common pathogens were cytomegalovirus (n = 16, 57.1%) and Epstein-Barr virus (n = 13, 46.4%), followed by varicella zoster virus (n = 8, 28.6%), Toxoplasma gondii (n = 6, 21.4%), herpes simplex virus 2 (n = 6, 21.4%), herpes simplex virus 1 (n = 6, 21.4%), and Toxocara (n = 1, 3.6%). Mean initial and final visual acuity (logarithm of the minimum angle of resolution) were 1.3 ± 0.9 (Snellen ∼20/400) and 1.3 ± 1.1 (Snellen ∼20/400), respectively. Cytomegalovirus-positive eyes (n = 16, 61.5%) had a mean final visual acuity of 0.94 ± 1.1 (Snellen ∼20/175), whereas cytomegalovirus-negative eyes (n = 10, 38%) had a final visual acuity of 1.82 ± 1.0 (Snellen ∼20/1,320) ( P < 0.05). Main clinical features included intraocular inflammation (100%), retinal whitening (84.6%), immunosuppression (65.4%), retinal hemorrhage (38.5%), and retinal detachment (34.6%).

Conclusion: Cytomegalovirus or Epstein-Barr virus were common unique pathogens identified in multi-PCR-positive samples. Most patients with co-infection were immunosuppressed with a high rate of retinal detachment and poor final visual acuity. Cytomegalovirus-positive eyes had better visual outcomes compared with cytomegalovirus-negative eyes.

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.