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Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis
Purpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019....
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695359/ https://www.ncbi.nlm.nih.gov/pubmed/36579507 http://dx.doi.org/10.3390/jpm12111785 |
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author | Fitoussi, Léa Baptiste, Amandine Mainguy, Adam L’Honneur, Anne-Sophie Bojanova, Magdalena Dechartres, Agnès Rozenberg, Flore Bodaghi, Bahram Touhami, Sara |
author_facet | Fitoussi, Léa Baptiste, Amandine Mainguy, Adam L’Honneur, Anne-Sophie Bojanova, Magdalena Dechartres, Agnès Rozenberg, Flore Bodaghi, Bahram Touhami, Sara |
author_sort | Fitoussi, Léa |
collection | PubMed |
description | Purpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019. All patients received induction therapy with intravenous +/− intravitreal injections (IVI) of antivirals. Results: Forty-one eyes of 37 patients with a mean age of 56 years were included. Involved viruses were VZV (44%), CMV (37%) and HSV2 (19%). Acute retinal necrosis represented 51%, progressive outer retinal necrosis 12% and CMV retinitis 37% of eyes. Forty-six percent of patients were immunocompromised. Median BCVA was 0.7 LogMAR at baseline and 0.8 LogMAR after an average of 14.1 months. VNR bilateralized in 27% of cases after 32 months. Retinal detachment (RD) occurred in 27% of cases after a mean duration of 98 days. Factors associated with a “poor BCVA” at 1 month were: advanced age, low baseline BCVA, high vitritis grade and viral load (VL) at baseline and the “slow responder” status (i.e., VL decrease <50% after 2 weeks of treatment). Factors associated with RD were: advanced age, immunocompetence, low baseline BCVA, high vitritis grade at baseline and use of ≤5 IVIs. Conclusions: Clinical factors including advanced age, immunocompetence, low BCVA and high vitritis grade at baseline were associated with a poor prognosis. New virological factors were predictive of a poor outcome: high baseline VL and the “slow responder” status. Sequential intraocular fluid sampling might help prognosticate the outcomes of VNR. |
format | Online Article Text |
id | pubmed-9695359 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96953592022-11-26 Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis Fitoussi, Léa Baptiste, Amandine Mainguy, Adam L’Honneur, Anne-Sophie Bojanova, Magdalena Dechartres, Agnès Rozenberg, Flore Bodaghi, Bahram Touhami, Sara J Pers Med Article Purpose: Describe the clinical and virological characteristics of viral necrotizing retinitis (VNR) and assess its prognostic factors. Methods: Retrospective study (Pitié Salpêtrière Hospital, Paris) of consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019. All patients received induction therapy with intravenous +/− intravitreal injections (IVI) of antivirals. Results: Forty-one eyes of 37 patients with a mean age of 56 years were included. Involved viruses were VZV (44%), CMV (37%) and HSV2 (19%). Acute retinal necrosis represented 51%, progressive outer retinal necrosis 12% and CMV retinitis 37% of eyes. Forty-six percent of patients were immunocompromised. Median BCVA was 0.7 LogMAR at baseline and 0.8 LogMAR after an average of 14.1 months. VNR bilateralized in 27% of cases after 32 months. Retinal detachment (RD) occurred in 27% of cases after a mean duration of 98 days. Factors associated with a “poor BCVA” at 1 month were: advanced age, low baseline BCVA, high vitritis grade and viral load (VL) at baseline and the “slow responder” status (i.e., VL decrease <50% after 2 weeks of treatment). Factors associated with RD were: advanced age, immunocompetence, low baseline BCVA, high vitritis grade at baseline and use of ≤5 IVIs. Conclusions: Clinical factors including advanced age, immunocompetence, low BCVA and high vitritis grade at baseline were associated with a poor prognosis. New virological factors were predictive of a poor outcome: high baseline VL and the “slow responder” status. Sequential intraocular fluid sampling might help prognosticate the outcomes of VNR. MDPI 2022-10-29 /pmc/articles/PMC9695359/ /pubmed/36579507 http://dx.doi.org/10.3390/jpm12111785 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Fitoussi, Léa Baptiste, Amandine Mainguy, Adam L’Honneur, Anne-Sophie Bojanova, Magdalena Dechartres, Agnès Rozenberg, Flore Bodaghi, Bahram Touhami, Sara Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title_full | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title_fullStr | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title_full_unstemmed | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title_short | Clinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis |
title_sort | clinical and virological characteristics and prognostic factors in viral necrotizing retinitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695359/ https://www.ncbi.nlm.nih.gov/pubmed/36579507 http://dx.doi.org/10.3390/jpm12111785 |
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