Классификация цитомегаловирусного ретинита, основанная на результатах полимеразной цепной реакции внутриглазной жидкости

Abstract

Original article Classification of cytomegalovirus retinitis based on the results of polymerase chain reaction of intraocular fluid Boris S. Pershin, Aleksey A. Maschan, Anna B. Smirnova, Olga N. Mironenko D. Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation Purpose. To present a new classification of cytomegalovirus retinitis. Material and methods. The work includes two parts: 1) determination of the relationship between the dynamics of the results of quantitative polymerase chain reaction of intraocular fluid and changes in the area of retinonecrosis foci; 2) evaluation of possible cytomegalovirus retinitis relapse depending on the results of the polymerase chain reaction of intraocular fluid at the end of treatment. First part: 48 patients with cytomegalovirus retinitis in the early period after hematopoietic stem cell transplantation (81 eyes, 778 observations). Once a week, patients received intravitreal administration of antiviral drugs with intraocular fluid intake until remission of retinonecrosis was achieved. Simultaneously with these manipulations, photoregistration of images of the posterior segment of the eyeball was carried out. The second part: 37 patients (62 eyes and 81 episodes). All episodes of cytomegalovirus retinitis that had at least one observation after achieving remission were studied. Results. The first part: a positive, close to strong correlation was determined between the results of the polymerase chain reaction of intraocular fluid and the area of retinonecrosis during observation of each eye. This makes it possible to evaluate the activity of cytomegalovirus retinitis by the actual results of the polymerase chain reaction of intraocular fluid. The second part: non-zero results of the polymerase chain reaction of intraocular fluid at the end of treatment, as well as in cases where remission is recorded based on ophthalmoscopy data, the probability of relapse of retinonecrosis is greater than in cases of complete elimination of the virus from the intraocular fluid. The proposed classification is suitable for the treatment of cytomegalovirus retinitis.