To the question of retinal detachment in cytomegalovirus uveitis in HIV-infected patients: treatment outcomes

Cytomegalovirus uveitis (CMV-uveitis) is one of the most common causes of vision loss in HIV-infected patients. The purpose is to characterize the clinical features of the course of retinal detachment in HIV infection. Material and methods. The study group included 29 patients, 34 eyes (9 men and 20 women). All patients underwent a standard routine ophthalmological examination. To confirm the diagnosis, an ultrasound of the eyeball was performed. Results. The following forms of retinal detachment were identified: acute retinal necrosis, regmatogenic and traction detachment. In 50% of cases, the disease occurred as acute retinal necrosis of CMV-etiology. Visual acuity in the group of patients with operated retinal detachment became significantly lower after complex treatment. Conclusions. CMV-uveitis has a chronic sluggish course, despite multicomponent treatment. Key words: cytomegalovirus, uveitis, HIV, HIV-infection, AIDS, retinal detachment.

The role of intraocular f luid polymerase chain reaction in the diagnosis, treatment and monitoring of cytomegalovirus retinitis

Purpose. To study the possibilities of a new method of CMRR treatment in the prevention of irreversible blindness. Material and methods. 74 patients with cytomegalovirus retinitis, frolicking after hematopoietic stem cell transplantation. The first group (9 people, 15 eyes) consisted of children, whose treatment was carried out under ophthalmoscopic control. The second group (65 people, 114 eyes) consisted of children in whom the control of the effectiveness of treatment was carried out using PCR of aqueous humor in real time. Results. In the first group, retinal detachment was diagnosed in three out of fifteen eyes, accounting for 20%. In the second group, the incidence of retinal detachment was 3.5% of 114 eyes. Among patients receiving treatment under ophthalmoscopic control, CMRR relapses were detected in 5 cases, which amounted to 33.3%. In children, whose treatment was controlled by intraocular fluid PCR, relapses were diagnosed in 22 cases, which amounted to 19.29%. Conclusions. Intravitreal administration of antiviral drugs under the control of polymerase chain reaction is a more effective method of treating cytomegalovirus retinitis than intravitreal administration under ophthalmoscopic control. Key words: cytomegalovirus retinitis, intraocular fluid polymerase chain reaction.

Differential diagnosis of active and inactive forms of cytomegalovirus retinitis

Purpose. Present the results of a study on the differential diagnosis of active and inactive forms of cytomegalovirus retinitis. Material and methods. 29 patients with cytomegalovirus retinitis, who underwent weekly fundus fluorescence angiography and intraocular fluid polymerase chain reaction during treatment. Results. Residual contrast fluorescence in the zone of cytomegalovirus retinitis foci was assessed on a scale from 0 to 4. The correlation between the intensity of contrast fluorescence in the fundus and the number of virus copies in the moisture of the anterior chamber was determined. The median of Spearman's criteria for the studied group of patients was 0.49. Conclusion. A positive relationship was revealed between the residual luminescence of CMR foci on PAH in the delayed phase of the study and the PCR values of the intraocular fluid, which makes it possible to rely on angiography data for the differential diagnosis of active and inactive CMRR. Key words: cytomegalovirus retinitis, fluorescein angiography.