Systemic risk factors and epidemiology of cytomegalovirus retinitis status-post allogeneic bone marrow hematopoietic stem cell transplantation_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhang Chuan , Li Xiaoxin , Miao Heng ,  Hou Jing

Department of Ophthalmology, People’s Hospital of Peking University, Beijing 100133, China;

Corresponding author：

Hou Jing, Email: drhoujing@163.com

Keywords：

Cytomegalovirus retinitis; Hematopoietic stem cell transplantation; Risk factors; Epidemiology; Review

DOI：

10.3760/cma.j.cn511434-20200218-00063

Video：

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Abstract Full text Figures/Tables Video References Cited by

Cytomegalovirus (CMV) retinitis (CMVR) is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases. It often occurs within 3 months after the operation, with CMV activation and high blood CMV peaks. It often occurs on patients with long-term CMV viremia, human leukocyte antigen incompatible transplantation, unrelated donor transplantation, haploid transplantation, childhood hematopoietic stem cell transplantation, delayed lymphocyte engraftment, acute and chronic graft-versus-host disease after surgery. The visual prognosis of patients is related to the area of CMVR lesions on the retina, the number of quadrants involved, whether the macula is involved, and the CMV load of the vitreous body is involved, and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor. The incidence of CMVR is increasing year by year. It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment, help patients improve the prognosis of vision, and reduce or even avoid the occurrence of blindness caused by CMVR.

Citation： Zhang Chuan, Li Xiaoxin, Miao Heng, Hou Jing. Systemic risk factors and epidemiology of cytomegalovirus retinitis status-post allogeneic bone marrow hematopoietic stem cell transplantation. Chinese Journal of Ocular Fundus Diseases, 2021, 37(5): 404-408. doi: 10.3760/cma.j.cn511434-20200218-00063 Copy

1.	Mori T. Management of cytomegalovirus infection after hematopoietic stem cell transplantation[J]. Rinsho Ketsueki, 2019, 60(9): 1337-1340. DOI: 10.11406/rinketsu.60.1337.
2.	Yan CH, Wang Y, Mo XD, et al. Incidence, risk factors, and outcomes of cytomegalovirus retinitis after haploidentical hematopoietic stem cell transplantation[J]. Bone Marrow Transplant, 2020, 55(6): 1147-1160. DOI: 10.1038/s41409-020-0790-z.
3.	Hassan-Moosa R, Chinappa T, Jeena L, et al. Cytomegalovirus retinitis and HIV: case reviews from KwaZulu-Natal Province, South Africa[J]. S Afr Med J, 2017, 107(10): 843-846. DOI: 10.7196/SAMJ.2017.v107i10.12740.
4.	Jirawison C, Yen M, Leenasirimakul P, et al. Telemedicine screening for cytomegalovirus retinitis at the point of care for human immunodeficiency virus infection[J]. JAMA Ophthalmol, 2015, 133(2): 198-205. DOI: 10.1001/jamaophthalmol.2014.4766.
5.	Hiwarkar P, Gajdosova E, Qasim W, et al. Frequent occurrence of cytomegalovirus retinitis during immune reconstitution warrants regular ophthalmic screening in high-risk pediatric allogeneic hematopoietic stem cell transplant recipients[J]. Clin Infect Dis, 2014, 58(12): 1700-1706. DOI: 10.1093/cid/ciu201.
6.	Parmesar K, Raj K. Haploidentical stem cell transplantation in adult haematological malignancies[J/OL]. Adv Hematol, 2016, 2016: 3905907[2016-05-30]. https://pubmed.ncbi.nlm.nih.gov/27313619/. DOI: 10.1155/2016/3905907.
7.	Kim T, Lee YM, Lee SO, et al. Differences of cytomegalovirus diseases between kidney and hematopoietic stem cell transplant recipients during preemptive therapy[J]. Korean J Intern Med, 2016, 31(5): 961-970. DOI: 10.3904/kjim.2015.079.
8.	Wolf DG, Lurain NS, Zuckerman T, et al. Emergence of late cytomegalovirus central nervous system disease in hematopoietic stem cell transplant recipients[J]. Blood, 2003, 101(2): 463-465. DOI: 10.1182/blood-2002-07-1982.
9.	Jabs DA, Ahuja A, Van Natta ML, et al. Long-term outcomes of cytomegalovirus retinitis in the era of modern antiretroviral therapy: results from a united states cohort[J]. Ophthalmology, 2015, 122(7): 1452-1463. DOI: 10.1016/j.ophtha.2015.02.033.
10.	Crippa F, Corey L, Chuang EL, et al. Virological, clinical, and ophthalmologic features of cytomegalovirus retinitis after hematopoietic stem cell transplantation[J]. Clin Infect Dis, 2001, 32(2): 214-219. DOI: 10.1086/318447.
11.	La Rosa C, Diamond DJ. The immune response to human CMV[J]. Future Virol, 2012, 7(3): 279-293. DOI: 10.2217/fvl.12.8.
12.	Aubert G, Hassan-Walker AF, Madrigal JA, et al. Cytomegalovirus-specific cellular immune responses and viremia in recipients of allogeneic stem cell transplants[J]. J Infect Dis, 2001, 184(8): 955-963. DOI: 10.1086/323354.
13.	Ljungman P, Brand R, Einsele H, et al. Donor CMV serologic status and outcome of CMV-seropositive recipients after unrelated donor stem cell transplantation: an EBMT megafile analysis[J]. Blood, 2003, 102(13): 4255-4260. DOI: 10.1182/blood-2002-10-3263.
14.	Boeckh M, Leisenring W, Riddell SR, et al. Late cytomegalovirus disease and mortality in recipients of allogeneic hematopoietic stem cell transplants: importance of viral load and T-cell immunity[J]. Blood, 2003, 101(2): 407-414. DOI: 10.1182/blood-2002-03-0993.
15.	Ozdemir E, St John LS, Gillespie G, et al. Cytomegalovirus reactivation following allogeneic stem cell transplantation is associated with the presence of dysfunctional antigen-specific CD8+ T cells[J]. Blood, 2002, 100(10): 3690-3697. DOI: 10.1182/blood-2002-05-1387.
16.	Krol L, Stuchly J, Hubacek P, et al. Signature profiles of CMV-specific T-cells in patients with CMV reactivation after hematopoietic SCT[J]. Bone Marrow Transplant, 2011, 46(8): 1089-1098. DOI: 10.1038/bmt.2010.261.
17.	Ozdemir E, Saliba RM, Champlin RE, et al. Risk factors associated with late cytomegalovirus reactivation after allogeneic stem cell transplantation for hematological malignancies[J]. Bone Marrow Transplant, 2007, 40(2): 125-136. DOI: 10.1038/sj.bmt.1705699.
18.	Rubie H, Attal M, Campardou AM, et al. Risk factors for cytomegalovirus infection in BMT recipients transfused exclusively with seronegative blood products[J]. Bone Marrow Transplant, 1993, 11(3): 209-214.
19.	Camargo JF, Komanduri KV. Emerging concepts in cytomegalovirus infection following hematopoietic stem cell transplantation[J]. Hematol Oncol Stem Cell Ther, 2017, 10(4): 233-238. DOI: 10.1016/j.hemonc.2017.05.001.
20.	Lin TS, Zahrieh D, Weller E, et al. Risk factors for cytomegalovirus reactivation after CD6+ T-cell-depleted allogeneic bone marrow transplantation[J]. Transplantation, 2002, 74(1): 49-54. DOI: 10.1097/00007890-200207150-00009.
21.	Saavedra S, Jarque I, Sanz GF, et al. Infectious complications in patients undergoing unrelated donor bone marrow transplantation: experience from a single institution[J]. Clin Microbiol Infect, 2002, 8(11): 725-733. DOI: 10.1046/j.1469-0691.2002.00458.x.
22.	George B, Mathews V, Srivastava A, et al. Infections among allogeneic bone marrow transplant recipients in India[J]. Bone Marrow Transplant, 2004, 33(3): 311-315. DOI: 10.1038/sj.bmt.1704347.
23.	Xhaard A, Robin M, Scieux C, et al. Increased incidence of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation[J]. Transplantation, 2007, 83(1): 80-83. DOI: 10.1097/01.tp.0000239512.94181.e9.
24.	Zhang M, Xin H, Roon P, et al. Infection of retinal neurons during murine cytomegalovirus retinitis[J]. Invest Ophthalmol Vis Sci, 2005, 46(6): 2047-2055. DOI: 10.1167/iovs.05-0005.
25.	Chiou SH, Liu JH, Chen SS, et al. Apoptosis of human retina and retinal pigment cells induced by human cytomegalovirus infection[J]. Ophthalmic Res, 2002, 34(2): 77-82. DOI: 10.1159/000048332.
26.	Jeon S, Lee WK, Lee Y, et al. Risk factors for cytomegalovirus retinitis in patients with cytomegalovirus viremia after hematopoietic stem cell transplantation[J]. Ophthalmology, 2012, 119(9): 1892-1898. DOI: 10.1016/j.ophtha.2012.03.032.
27.	Tufail A, Moe AA, Miller MJ, et al. Quantitative cytomegalovirus DNA level in the blood and its relationship to cytomegalovirus retinitis in patients with acquired immune deficiency syndrome[J]. Ophthalmology, 1999, 106(1): 133-141. DOI: 10.1016/s0161-6420(99)90015-5.
28.	El Amari EB, Combescure C, Yerly S, et al. Clinical relevance of cytomegalovirus viraemia (*, †)[J]. HIV Med, 2011, 12(7): 394-402. DOI: 10.1111/j.1468-1293.2010.00900.x.
29.	Asano-Mori Y, Kanda Y, Oshima K, et al. Clinical features of late cytomegalovirus infection after hematopoietic stem cell transplantation[J]. Int J Hematol, 2008, 87(3): 310-318. DOI: 10.1007/s12185-008-0051-1.
30.	Nademanee A, Schmidt GM, Parker P, et al. The outcome of matched unrelated donor bone marrow transplantation in patients with hematologic malignancies using molecular typing for donor selection and graft-versus-host disease prophylaxis regimen of cyclosporine, methotrexate, and prednisone[J]. Blood, 1995, 86(3): 1228-1234. DOI: 10.1182/blood.V86.3.1228.1228.
31.	Petersdorf EW, Longton GM, Anasetti C, et al. The significance of HLA-DRB1 matching on clinical outcome after HLA-A, B, DR identical unrelated donor marrow transplantation[J]. Blood, 1995, 86(4): 1606-1613. DOI: 10.1182/blood.V86.4.1606.bloodjournal8641606.
32.	Small TN, Avigan D, Dupont B, et al. Immune reconstitution following T-cell depleted bone marrow transplantation: effect of age and posttransplant graft rejection prophylaxis[J]. Biol Blood Marrow Transplant, 1997, 3(2): 65-75.
33.	Lu DP, Dong L, Wu T, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation[J]. Blood, 2006, 107(8): 3065-3073. DOI: 10.1182/blood-2005-05-2146.
34.	Aw MM, Murugasu B, Tan AW, et al. Quantitation of peripheral blood cytomegalovirus DNA for monitoring recurrent cytomegalovirus retinitis in pediatric solid organ transplant recipients[J]. Pediatr Transplant, 2000, 4(2): 100-106. DOI: 10.1034/j.1399-3046.2000.00095.x.
35.	Gupta S, Vemulakonda GA, Suhler EB, et al. Cytomegalovirus retinitis in the absence of AIDS[J]. Can J Ophthalmol, 2013, 48(2): 126-129. DOI: 10.1016/j.jcjo.2012.12.002.
36.	Haze M, Kobayashi T, Kakurai K, et al. Bilateral cytomegalovirus retinitis in a patient with systemic lupus erythematosus[J]. Case Rep Ophthalmol, 2016, 7(2): 303-308. DOI: 10.1159/000446391.
37.	Shulman HM, Sullivan KM, Weiden PL, et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 seattle patients[J]. Am J Med, 1980, 69(2): 204-217. DOI: 10.1016/0002-9343(80)90380-0.
38.	Przepiorka D, Weisdorf D, Martin P, et al. 1994 consensus conference on acute GVHD grading[J]. Bone Marrow Transplant, 1995, 15(6): 825-828.
39.	Thorne JE, Holbrook JT, Jabs DA, et al. Effect of cytomegalovirus retinitis on the risk of visual acuity loss among patients with AIDS[J]. Ophthalmology, 2007, 114(3): 591-598. DOI: 10.1016/j.ophtha.2006.08.008.
40.	Iu LP, Fan MC, Lau JK, et al. Long-term follow-up of cytomegalovirus retinitis in non-HIV immunocompromised patients: clinical features and visual prognosis[J]. Am J Ophthalmol, 2016, 165: 145-153. DOI: 10.1016/j.ajo.2016.03.015.
41.	Zhang Y, Ruan X, Yang W, et al. High ocular CMV copies and mismatched receipts may predict poor visual prognosis in CMV retinitis patients following allogeneic haematopoietic stem cell transplantation[J/OL]. BMC Ophthalmol, 2017, 17(1): 224[2017-11-29]. https://pubmed.ncbi.nlm.nih.gov/29187167/. DOI: 10.1186/s12886-017-0622-0.
42.	Holbrook JT, Jabs DA, Weinberg DV, et al. Visual loss in patients with cytomegalovirus retinitis and acquired immunodeficiency syndrome before widespread availability of highly active antiretroviral therapy[J]. Arch Ophthalmol, 2003, 121(1): 99-107. DOI: 10.1001/archopht.121.1.99.
43.	Eid AJ, Bakri SJ, Kijpittayarit S, et al. Clinical features and outcomes of cytomegalovirus retinitis after transplantation[J]. Transpl Infect Dis, 2008, 10(1): 13-18. DOI: 10.1111/j.1399-3062.2007.00241.x.

1. Mori T. Management of cytomegalovirus infection after hematopoietic stem cell transplantation[J]. Rinsho Ketsueki, 2019, 60(9): 1337-1340. DOI: 10.11406/rinketsu.60.1337.
2. Yan CH, Wang Y, Mo XD, et al. Incidence, risk factors, and outcomes of cytomegalovirus retinitis after haploidentical hematopoietic stem cell transplantation[J]. Bone Marrow Transplant, 2020, 55(6): 1147-1160. DOI: 10.1038/s41409-020-0790-z.
3. Hassan-Moosa R, Chinappa T, Jeena L, et al. Cytomegalovirus retinitis and HIV: case reviews from KwaZulu-Natal Province, South Africa[J]. S Afr Med J, 2017, 107(10): 843-846. DOI: 10.7196/SAMJ.2017.v107i10.12740.
4. Jirawison C, Yen M, Leenasirimakul P, et al. Telemedicine screening for cytomegalovirus retinitis at the point of care for human immunodeficiency virus infection[J]. JAMA Ophthalmol, 2015, 133(2): 198-205. DOI: 10.1001/jamaophthalmol.2014.4766.
5. Hiwarkar P, Gajdosova E, Qasim W, et al. Frequent occurrence of cytomegalovirus retinitis during immune reconstitution warrants regular ophthalmic screening in high-risk pediatric allogeneic hematopoietic stem cell transplant recipients[J]. Clin Infect Dis, 2014, 58(12): 1700-1706. DOI: 10.1093/cid/ciu201.
6. Parmesar K, Raj K. Haploidentical stem cell transplantation in adult haematological malignancies[J/OL]. Adv Hematol, 2016, 2016: 3905907[2016-05-30]. https://pubmed.ncbi.nlm.nih.gov/27313619/. DOI: 10.1155/2016/3905907.
7. Kim T, Lee YM, Lee SO, et al. Differences of cytomegalovirus diseases between kidney and hematopoietic stem cell transplant recipients during preemptive therapy[J]. Korean J Intern Med, 2016, 31(5): 961-970. DOI: 10.3904/kjim.2015.079.
8. Wolf DG, Lurain NS, Zuckerman T, et al. Emergence of late cytomegalovirus central nervous system disease in hematopoietic stem cell transplant recipients[J]. Blood, 2003, 101(2): 463-465. DOI: 10.1182/blood-2002-07-1982.
9. Jabs DA, Ahuja A, Van Natta ML, et al. Long-term outcomes of cytomegalovirus retinitis in the era of modern antiretroviral therapy: results from a united states cohort[J]. Ophthalmology, 2015, 122(7): 1452-1463. DOI: 10.1016/j.ophtha.2015.02.033.
10. Crippa F, Corey L, Chuang EL, et al. Virological, clinical, and ophthalmologic features of cytomegalovirus retinitis after hematopoietic stem cell transplantation[J]. Clin Infect Dis, 2001, 32(2): 214-219. DOI: 10.1086/318447.
11. La Rosa C, Diamond DJ. The immune response to human CMV[J]. Future Virol, 2012, 7(3): 279-293. DOI: 10.2217/fvl.12.8.
12. Aubert G, Hassan-Walker AF, Madrigal JA, et al. Cytomegalovirus-specific cellular immune responses and viremia in recipients of allogeneic stem cell transplants[J]. J Infect Dis, 2001, 184(8): 955-963. DOI: 10.1086/323354.
13. Ljungman P, Brand R, Einsele H, et al. Donor CMV serologic status and outcome of CMV-seropositive recipients after unrelated donor stem cell transplantation: an EBMT megafile analysis[J]. Blood, 2003, 102(13): 4255-4260. DOI: 10.1182/blood-2002-10-3263.
14. Boeckh M, Leisenring W, Riddell SR, et al. Late cytomegalovirus disease and mortality in recipients of allogeneic hematopoietic stem cell transplants: importance of viral load and T-cell immunity[J]. Blood, 2003, 101(2): 407-414. DOI: 10.1182/blood-2002-03-0993.
15. Ozdemir E, St John LS, Gillespie G, et al. Cytomegalovirus reactivation following allogeneic stem cell transplantation is associated with the presence of dysfunctional antigen-specific CD8+ T cells[J]. Blood, 2002, 100(10): 3690-3697. DOI: 10.1182/blood-2002-05-1387.
16. Krol L, Stuchly J, Hubacek P, et al. Signature profiles of CMV-specific T-cells in patients with CMV reactivation after hematopoietic SCT[J]. Bone Marrow Transplant, 2011, 46(8): 1089-1098. DOI: 10.1038/bmt.2010.261.
17. Ozdemir E, Saliba RM, Champlin RE, et al. Risk factors associated with late cytomegalovirus reactivation after allogeneic stem cell transplantation for hematological malignancies[J]. Bone Marrow Transplant, 2007, 40(2): 125-136. DOI: 10.1038/sj.bmt.1705699.
18. Rubie H, Attal M, Campardou AM, et al. Risk factors for cytomegalovirus infection in BMT recipients transfused exclusively with seronegative blood products[J]. Bone Marrow Transplant, 1993, 11(3): 209-214.
19. Camargo JF, Komanduri KV. Emerging concepts in cytomegalovirus infection following hematopoietic stem cell transplantation[J]. Hematol Oncol Stem Cell Ther, 2017, 10(4): 233-238. DOI: 10.1016/j.hemonc.2017.05.001.
20. Lin TS, Zahrieh D, Weller E, et al. Risk factors for cytomegalovirus reactivation after CD6+ T-cell-depleted allogeneic bone marrow transplantation[J]. Transplantation, 2002, 74(1): 49-54. DOI: 10.1097/00007890-200207150-00009.
21. Saavedra S, Jarque I, Sanz GF, et al. Infectious complications in patients undergoing unrelated donor bone marrow transplantation: experience from a single institution[J]. Clin Microbiol Infect, 2002, 8(11): 725-733. DOI: 10.1046/j.1469-0691.2002.00458.x.
22. George B, Mathews V, Srivastava A, et al. Infections among allogeneic bone marrow transplant recipients in India[J]. Bone Marrow Transplant, 2004, 33(3): 311-315. DOI: 10.1038/sj.bmt.1704347.
23. Xhaard A, Robin M, Scieux C, et al. Increased incidence of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation[J]. Transplantation, 2007, 83(1): 80-83. DOI: 10.1097/01.tp.0000239512.94181.e9.
24. Zhang M, Xin H, Roon P, et al. Infection of retinal neurons during murine cytomegalovirus retinitis[J]. Invest Ophthalmol Vis Sci, 2005, 46(6): 2047-2055. DOI: 10.1167/iovs.05-0005.
25. Chiou SH, Liu JH, Chen SS, et al. Apoptosis of human retina and retinal pigment cells induced by human cytomegalovirus infection[J]. Ophthalmic Res, 2002, 34(2): 77-82. DOI: 10.1159/000048332.
26. Jeon S, Lee WK, Lee Y, et al. Risk factors for cytomegalovirus retinitis in patients with cytomegalovirus viremia after hematopoietic stem cell transplantation[J]. Ophthalmology, 2012, 119(9): 1892-1898. DOI: 10.1016/j.ophtha.2012.03.032.
27. Tufail A, Moe AA, Miller MJ, et al. Quantitative cytomegalovirus DNA level in the blood and its relationship to cytomegalovirus retinitis in patients with acquired immune deficiency syndrome[J]. Ophthalmology, 1999, 106(1): 133-141. DOI: 10.1016/s0161-6420(99)90015-5.
28. El Amari EB, Combescure C, Yerly S, et al. Clinical relevance of cytomegalovirus viraemia (*, †)[J]. HIV Med, 2011, 12(7): 394-402. DOI: 10.1111/j.1468-1293.2010.00900.x.
29. Asano-Mori Y, Kanda Y, Oshima K, et al. Clinical features of late cytomegalovirus infection after hematopoietic stem cell transplantation[J]. Int J Hematol, 2008, 87(3): 310-318. DOI: 10.1007/s12185-008-0051-1.
30. Nademanee A, Schmidt GM, Parker P, et al. The outcome of matched unrelated donor bone marrow transplantation in patients with hematologic malignancies using molecular typing for donor selection and graft-versus-host disease prophylaxis regimen of cyclosporine, methotrexate, and prednisone[J]. Blood, 1995, 86(3): 1228-1234. DOI: 10.1182/blood.V86.3.1228.1228.
31. Petersdorf EW, Longton GM, Anasetti C, et al. The significance of HLA-DRB1 matching on clinical outcome after HLA-A, B, DR identical unrelated donor marrow transplantation[J]. Blood, 1995, 86(4): 1606-1613. DOI: 10.1182/blood.V86.4.1606.bloodjournal8641606.
32. Small TN, Avigan D, Dupont B, et al. Immune reconstitution following T-cell depleted bone marrow transplantation: effect of age and posttransplant graft rejection prophylaxis[J]. Biol Blood Marrow Transplant, 1997, 3(2): 65-75.
33. Lu DP, Dong L, Wu T, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation[J]. Blood, 2006, 107(8): 3065-3073. DOI: 10.1182/blood-2005-05-2146.
34. Aw MM, Murugasu B, Tan AW, et al. Quantitation of peripheral blood cytomegalovirus DNA for monitoring recurrent cytomegalovirus retinitis in pediatric solid organ transplant recipients[J]. Pediatr Transplant, 2000, 4(2): 100-106. DOI: 10.1034/j.1399-3046.2000.00095.x.
35. Gupta S, Vemulakonda GA, Suhler EB, et al. Cytomegalovirus retinitis in the absence of AIDS[J]. Can J Ophthalmol, 2013, 48(2): 126-129. DOI: 10.1016/j.jcjo.2012.12.002.
36. Haze M, Kobayashi T, Kakurai K, et al. Bilateral cytomegalovirus retinitis in a patient with systemic lupus erythematosus[J]. Case Rep Ophthalmol, 2016, 7(2): 303-308. DOI: 10.1159/000446391.
37. Shulman HM, Sullivan KM, Weiden PL, et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 seattle patients[J]. Am J Med, 1980, 69(2): 204-217. DOI: 10.1016/0002-9343(80)90380-0.
38. Przepiorka D, Weisdorf D, Martin P, et al. 1994 consensus conference on acute GVHD grading[J]. Bone Marrow Transplant, 1995, 15(6): 825-828.
39. Thorne JE, Holbrook JT, Jabs DA, et al. Effect of cytomegalovirus retinitis on the risk of visual acuity loss among patients with AIDS[J]. Ophthalmology, 2007, 114(3): 591-598. DOI: 10.1016/j.ophtha.2006.08.008.
40. Iu LP, Fan MC, Lau JK, et al. Long-term follow-up of cytomegalovirus retinitis in non-HIV immunocompromised patients: clinical features and visual prognosis[J]. Am J Ophthalmol, 2016, 165: 145-153. DOI: 10.1016/j.ajo.2016.03.015.
41. Zhang Y, Ruan X, Yang W, et al. High ocular CMV copies and mismatched receipts may predict poor visual prognosis in CMV retinitis patients following allogeneic haematopoietic stem cell transplantation[J/OL]. BMC Ophthalmol, 2017, 17(1): 224[2017-11-29]. https://pubmed.ncbi.nlm.nih.gov/29187167/. DOI: 10.1186/s12886-017-0622-0.
42. Holbrook JT, Jabs DA, Weinberg DV, et al. Visual loss in patients with cytomegalovirus retinitis and acquired immunodeficiency syndrome before widespread availability of highly active antiretroviral therapy[J]. Arch Ophthalmol, 2003, 121(1): 99-107. DOI: 10.1001/archopht.121.1.99.
43. Eid AJ, Bakri SJ, Kijpittayarit S, et al. Clinical features and outcomes of cytomegalovirus retinitis after transplantation[J]. Transpl Infect Dis, 2008, 10(1): 13-18. DOI: 10.1111/j.1399-3062.2007.00241.x.

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Systemic risk factors and epidemiology of cytomegalovirus retinitis status-post allogeneic bone marrow hematopoietic stem cell transplantation

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