The image characteristics of optical coherence tomography in patients of acquired immunodeficiency syndrome with cytomegalovirus retinitis_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Shengnan ,  Sun Huiyu , Mao Feifei , Li Dan , Lu Dan

Department of Ophthalmology, Beijing Ditan Hospital Capital Medical University, Beijing 100015, China;

Corresponding author：

Sun Huiyu, Email: sunhuiyu123@126.com

Keywords：

Acquired immunodeficiency syndrome/complications; Cytomegalovirus retinitis/diagnosis; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2020.01.002

Video：

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Objective To observe the image characteristics of OCT in patients of acquired immunodeficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR).Methods Thirty-nine eyes of 26 patients of AIDS with CMVR diagnosed in Department of ophthalmology of Beijing Ditan Hospital Capital Medical University from January 2015 to December 2017 were included in this study. All the patients were males, with the mean age of 33.12±9.87 years. All the patients underwent the OCT examination by Spectralis HRA+OCT. The locations of scanning were macular, optical papilla and posterior pole of retina with retinitis. Typical images were saved and analyzed.Results The OCT pathological changes of CMVR included increase of retinal thickness and reflex of retina, indiscernible retinal layers, irregularity or absent external limiting membrane and/or ellipsoid zone, hyperreflective spots, vitreous cells. Among 39 eyes, there were 6 eyes with strong point-like reflection in the outer layer of retina around the lesion, 31 eyes (79.49%) with strong point-like reflection in the full layer of retina, 25 eyes (64.10%) with lesion involved macular area, 34 eyes (87.17%) with vitreous cells.Conclusions OCT images of the eyes with AIDS with CMVR were characterized by lesions involving the whole retina. Absent ellipsoid zone or structural changes can be seen in the affected areas and peripheral areas of the lesion.

Citation： Wang Shengnan, Sun Huiyu, Mao Feifei, Li Dan, Lu Dan. The image characteristics of optical coherence tomography in patients of acquired immunodeficiency syndrome with cytomegalovirus retinitis. Chinese Journal of Ocular Fundus Diseases, 2020, 36(1): 5-9. doi: 10.3760/cma.j.issn.1005-1015.2020.01.002 Copy

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21.	Wakabayashi T, Oshima Y, Fujimoto H, et al. Foveal microstructure and visual acuity after retinal detachment repair: imaging analysis by Fourier-domain optical coherence tomography[J]. Ophthalmology, 2009, 116(3): 519-528. DOI: 10.1016/j.ophtha.2008.10.001.
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1. Goldberg DE, Smithen LM, Angelilli A, et al. HIV-associated retinopathy in the HAART era[J]. Retina, 2005, 25(5): 633-649. DOI: 10.1097/00006982-200507000-00015.
2. Sugar EA, Jabs DA, Ahuja A, et al. Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy[J]. Am J Ophthalmol, 2012, 153(6): 1016-1024. DOI: 10.1016/j.ajo.2011.11.014.
3. Hee MR, Izatt JA, Swanson EA, et al. Optical coherence tomography of the human retina[J]. Arch Ophthalmol, 1995, 113(3): 325-332. DOI: 10.1001/archopht.1995.01100030081025.
4. Govetto A, Virgili G, Rodriguez FJ, et al. Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: surgical results at 12 months[J]. Retina, 2019, 39(2): 347-357. DOI: 10.1097/IAE.0000000000001940.
5. Swanson EA, Fujimoto JG. The ecosystem that powered the translation of OCT from fundamental research to clinical and commercial impact[J]. Biomed Opt Express, 2017, 8(3): 1638-1644. DOI: 10.1364/BOE.8.001638.
6. Lee CS, Baughman DM, Lee AY. Deep learning is effective for the classification of OCT images of normal versus age-related macular degeneration[J]. Ophthalmol Retina, 2017, 1(4): 322-327. DOI: 10.1016/j.oret.2016.12.009.
7. Giano A, Sabella P, Eandi CM, et al. Spectral-domain optical coherence tomography findings in a case of frosted branch angiitis[J]. Eye (Lond), 2010, 24(5): 941-943. DOI: 10.1038/eye.2009.228.
8. Kurup SP, Khan S, Gill MK. Spectral domain optical coherence tomography in the evaluation and management of infectious retinitis[J]. Retina, 2014, 34(11): 2233-2241. DOI: 10.1097/IAE.0000000000000218.
9. Arichika S, Uji A, Yoshimura N. Retinal structural features of cytomegalovirus retinitis with acquired immunodeficiency syndrome: an adaptive optics imaging and optical coherence tomography study[J]. Clin Exp Ophthalmol, 2016, 44(1): 62-64. DOI: 10.1111/ceo.12577.
10. Kirwin SJ, Kanaly ST, Hansen CR, et al. Retinal gene expression and visually evoked behavior in diabetic long evans rats[J]. Invest Ophthalmol Vis Sci, 2011, 52(10): 7654-7663. DOI: 10.1167/iovs.10-6609.
11. Peng S, Wang SB, Singh D, et al. Claudin-3 and claudin-19 partially restore native phenotype to ARPE-19 cells via effects on tight junctions and gene expression[J]. Exp Eye Res, 2016, 151: 179-189. DOI: 10.1016/j.exer.2016.08.021.
12. Runkle EA, Antonetti DA. The blood-retinal barrier: structure and functional significance[J]. Methods Mol Biol, 2011, 686: 133-148. DOI: 10.1007/978-1-60761-938-3_5.
13. van Kooij B, Rothova A, Rijkers GT, et al. Distinct cytokine and chemokine profiles in the aqueous of patients with uveitis and cystoid macular edema[J]. Am J Ophthalmol, 2006, 142(1): 192-194. DOI: 10.1016/j.ajo.2006.02.052.
14. Khera TK, Dick AD, Nicholson LB. Mechanisms of TNFalpha regulation in uveitis: focus on RNA-birnding proteins[J]. Prog Retin Eye Res, 2010, 29(6): 610-621. DOI: 10.1016/j.preteyeres.2010.08.003.
15. Titchenell PM, Lin CM, Keil JM, et al. Novel atypical PKC inhibitors prevent vascular endothelial growth factor-induced blood-retinal barrier dysfunction[J]. Biochem J, 2012, 466(3): 455-467. DOI: 10.1042/BJ20111961.
16. Gulati N, Forooghian F, Lieberman R, et al. Vascular endothelial growth factor inhibition in uveitis: a systematic review[J]. Br J Ophthalmol, 2011, 95(2): 162-165. DOI: 10.1136/bjo.2009.177279.
17. Yeh S, Forooghian F, Faia L, et al. Fundus autofluoresence changes in cytomegalovirus retinitis[J]. Retina, 2010, 30(1): 42-50. DOI: 10.1097/IAE.0b013e3181bfbdb2.
18. Wilkerson I, Laban J, Mitchell JM, et al. Retinal pericytes and cytomegalovirus infectivity: implications for HCMV-induced retinopathy and congenital ocular disease[J/OL]. J Neuroinflammation, 2015, 12: 2[2015-01-09]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314746/. DOI: 10.1186/s12974-014-0219-y.
19. Hagiwara A, Mitamura Y, Kumagai K, et al. Photoreceptor impairment on optical coherence tomographic images in patients with retinitis pigmentosa[J]. Br J Ophthalmol, 2013, 97(2): 237-238. DOI: 10.1136/bjophthalmol-2012-302510.
20. Aizawa S, Mitamura Y, Hagiwara A, et al. Changes of fundus autofluorescence, photoreceptor inner and outer segment junction line, and visual function in patients with retinitis pigmentosa[J]. Clin Exp Ophthalmol, 2010, 38(6): 597-604. DOI: 10.1111/j.1442-9071.2010.02321.x.
21. Wakabayashi T, Oshima Y, Fujimoto H, et al. Foveal microstructure and visual acuity after retinal detachment repair: imaging analysis by Fourier-domain optical coherence tomography[J]. Ophthalmology, 2009, 116(3): 519-528. DOI: 10.1016/j.ophtha.2008.10.001.
22. Bottoni F, de Angelis S, Luccarelli S, et al. The dynamic healing process of idiopathic macular holes after surgical repair: a spectral-domain optical coherence tomography study[J]. Invest Ophthalmol Vis Sci, 2011, 52(7): 4439-4446. DOI: 10.1167/iovs.10-6732.

Chinese Journal of Ocular Fundus Diseases

The image characteristics of optical coherence tomography in patients of acquired immunodeficiency syndrome with cytomegalovirus retinitis

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