Visual functions in patients with cytomegalovirus uveitis and HIV infection

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: Cytomegalovirus damage to the eye is the leading cause of loss of visual functions associated with HIV. Effective treatment of HIV-infected patients has changed the understanding of the clinical picture of cytomegalovirus uveitis (CMV-uveitis).

AIM: The aim of the work is to determine the prevalence, the structure of clinical forms and to evaluate visual functions in HIV-infected patients with CMV-uveitis.

MATERIALS AND METHODS: The study group consisted of 66 HIV-infected patients with CMV-uveitis (97 eyes), of which there were 27 men (40.9%), 39 women (59.1%). The average age was 39.6 ± 3.91 years. All patients had stage 4B of HIV infection according to V.V. Pokrovsky’s classification (2006). During the work, visometry, perimetry, biomicroscopy, ophthalmoscopy were used.

RESULTS: The main form of the disease is chorioretinitis, diffuse and generalized forms of the disease are diagnosed in 68.0% of cases. In predicting visual acuity, the leading regression criterion was the clinical form of the disease.

CONCLUSIONS: Diffuse and generalized forms of the disease prevailed in clinical practice. Localization of the chorioretinal process of a predominantly diffuse nature predetermined visual acuity, which in more than a third of cases met the criteria for blindness according to the WHO classification (1977).

About the authors

Tatiana D. Sizova

Saint Petersburg Center for Control of AIDS and Infectious Diseases; North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: tanja_sizova@list.ru
ORCID iD: 0000-0003-4089-1242
SPIN-code: 2939-5495

Ophthalmologist, PhD Student

Russian Federation, Saint Petersburg; Saint Petersburg

Valentina M. Khokkanen

North-Western State Medical University named after I.I. Mechnikov

Email: valentina.khokkanen@szgmu.ru
ORCID iD: 0000-0001-8096-5088
SPIN-code: 6536-4889

Dr. Sci. (Med.), Professor, Professor of the Ophthalmology Department

Russian Federation, Saint Petersburg

Natalia G. Zumbulidze

North-Western State Medical University named after I.I. Mechnikov

Email: guramovna@gmail.com
ORCID iD: 0000-0002-7729-097X
SPIN-code: 4439-8855

Cand. Sci. (Med.), Associate Professor of Ophthalmology Department

Russian Federation, Saint Petersburg

Ernest V. Boiko

North-Western State Medical University named after I.I. Mechnikov; Kirov Military Medical Academy; S.N. Fyodorov Eye Microsurgery Federal State Institution, the Saint Petersburg Branch

Email: boiko111@list.ru
ORCID iD: 0000-0002-7413-7478
SPIN-code: 7589-2512

Dr. Sci. (Med.), Professor, Head of the Ophthalmology Department; Corresponding member of the Military Medical Academy; Director

Russian Federation, Saint Petersburg; Saint Petersburg; Saint Petersburg

References

  1. Kestelyn PG, Cunningham ET. HIV/AIDS and blindness. Bulletin of the World Health Organisation. 2001;79(3):208–213.
  2. 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. Arch Ophthalmol. 2003;121:99–107. doi: 10.1001/archopht.121.1.99
  3. Onishchenho AL, Kolbasko AV, Tatarnikova GN, Chernysheva AD. Retinal detachment in HIV-infected patients with cytomegalovirus retinitis. The Russian Annals of Ophthalmology. 2014;130(3):42–44. (In Russ.)
  4. Pantelleva OV, Bembeeva NA, Volkova TM, et al. (Saint Petersburg Center for the Prevention and Control of AIDS and Infectious Diseases, Saint Petersburg, Russia). Newsletter “HIV infection in Saint Petersburg as of January 01, 2021”. Saint Petersburg (Russia), 2021 [cited 2022 Aug 28]. Available at: https://www.hiv-spb.ru/lsn/informaczionnyie-byulleteni.html. (In Russ.)
  5. Kempen JH, Sugar EA, Lyon AT, et al. Studies of Ocular Complications of AIDS Research Group. Risk of cataract in persons with cytomegalovirus retinitis and the acquired immune deficiency syndrome. Ophthalmology. 2012;119(11):2343–2350. doi: 10.1016/j.ophtha.2012.05.044
  6. Cassoux N, Lumbroso L, Bodaghi B, et al. Cystoid macular oedema and cytomegalovirus retinitis in patients with HIV disease treated with highly active antiretroviral therapy. Br J Ophthalmol. 1999;83(1):47–49. doi: 10.1136/bjo.83.1.47
  7. Hizhnyak TV, Astahov YuS, Rahmanova AG. K voprosu o rannei diagnostike TsMV-retinita u bol’nykh VICh-infektsiei. Ophthalmology Journal. 2011;4(2):39–45. (In Russ.)
  8. Onischenko AL, Kolbasko AV, Tatarnikova GN, Chernysheva AD. Treatment of retinal separation in HIV-infected patients with cytomegalovirus retinitis. Ophthalmology in Russia. 2017;14(1):84–87. (In Russ.) doi: 10.18008/1816-5095-2017-1-84-87
  9. Gavrilova TV, Sergienko AP, Chereshneva MV, Sobianina AN. Eye damage at the terminal stage of HIV infection. Clinical case. Ophthalmology in Russia. 2021;18(2):368–373. (In Russ.) doi: 10.18008/1816-5095-2021-2-368-373
  10. Sizova TD, Khokkanen VM, Gusev DA, Boiko EV. Cytomegalovirus uveitis in HIV-infected patients: course and outcomes. Journal Infectology. 2020;12(4):45–50. (In Russ.) doi: 10.22625/2072-6732-2020-12-4-45-50
  11. Ando Y, Terao K, Narita M, et al. Quantitative analyses of cytomegalovirus genome in aqueous humor of patients with cytomegalovirus retinitis. Jpn J Ophthalmol. 2002;46(3):254–260. doi: 10.1016/s0021-5155(01)00524-x
  12. Chen C, Guo CG, Meng L, et al. Comparative analysis of cytomegalovirus retinitis and microvascular retinopathy in patients with acquired immunodeficiency syndrome. Int J Ophthalmol. 2017;10(9):1396–1401. doi: 10.18240/ijo.2017.09.11
  13. Tang S, Zhao N, Wang LY, Wen Y. Frosted branch angiitis due to cytomegalovirus-associated unmasking immune reconstitution inflammatory syndrome: a case report and literature review. BMC Infectious Diseases. 2021;21(1):613. doi: 10.1186/s12879-021-06311-4
  14. Li W, Wang X, Zhao L, et al. The value and implementation of routine ophthalmic examination in the era of HAART. EClinicalMedicine. 2020;31:100646. doi: 10.1016/j.eclinm.2020.100646
  15. Heiden D, Tun N, Smithuis FN, et al. Active cytomegalovirus retinitis after the start of antiretroviral therapy. Br J Ophthalmol. 2019;103(2):157–160. doi: 10.1136/bjophthalmol-2018-312406
  16. Sugar EA, Jabs DA, Ahuja A, et al. Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol. 2012;153(6):1016–1024. doi: 10.1016/j.ajo.2011.11.014
  17. Chakraborty A, Mahapatra T, Mahapatra S, et al. Distribution and determinants of cytomegalovirus induced end organ disease/s among people living with HIV/AIDS in a poor resource setting: observation from India. PLoS One. 2015;10(2): e0117466. doi: 10.1371/journal.pone.0117466
  18. Maksimov VJu, Dmitrieva OG, Evseev SJu, Aleksandrova NM. Diagnosis and treatment of uveitis of herpesvirus and chlamydia etiology. Russian Journal of Clinical Ophthalmology. 2003;4(4):168. (In Russ.)
  19. Kacnel’son LA, Tankovskij VJe. Uveitis (clinic, treatment). Moscow: 4-y filial Voenizdata; 2003. (In Russ.)
  20. Jabs DA, Nussenblatt RB, Rosenbaum JT.; Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005;140(3):509–516. doi: 10.1016/j.ajo.2005.03.057
  21. Federal clinical guidelines “Non-infectious uveitis in adults, 2019” [cited 2022 Sept 07]. Avaible at: https://oor.ru/files/uveity/uveity.pdf (In Russ.)

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Fundus photo of the patient at the detection of the disease. An example of diffuse chorioretinitis

Download (146KB)
3. Fig. 2. Optical coherence tomography of the macular area of patient 1 year after completion of etiotropic treatment

Download (114KB)
4. Fig. 3. Regression tree of visual acuity prediction. 0 — focal chorioretinitis, peripheral localization; 1 — focal chorioretinitis, сentral localization; 2 — diffuse chorioretinitis, peripheral localization; 3 — diffuse chorioretinitis with spread to the macular area; 4 — diffuse neurochorioretinitis with spread to the macular area; 5 — panuveitis

Download (159KB)

Copyright (c) 2022 Sizova T.D., Khokkanen V.M., Zumbulidze N.G., Boiko E.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies