Extralesional microvascular and structural macular abnormalities in cytomegalovirus retinitis

Nida Wongchaisuwat,Nopasak Phasukkijwatana,Sansanee Khongpipatchaisiri,Pitipol Choopong,Sutasinee Boonsopon,Nattaporn Tesavibul,Supalert Prakhunhungsit,Somanus Thoongsuwan,Nuttawut Rodanant

doi:10.1038/s41598-020-78587-6

Nida Wongchaisuwat, Nopasak Phasukkijwatana + Show 7 more

Open Access

https://doi.org/10.1038/s41598-020-78587-6

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Journal: Scientific Reports	Publication Date: Dec 1, 2020
Citations: 3	License type: open-access

Affiliation: Siriraj Hospital, Mahidol University

Abstract

To evaluate extralesional microvascular and structural changes of the macula using optical coherence tomography angiography (OCTA) and structural OCT in cytomegalovirus retinitis (CMVR). An observational study of CMVR patients were performed. Complete ophthalmic examination, serial color fundus photography, structural OCT and OCTA were performed at baseline and follow-up visits for up to 12 months. The structural OCT was analyzed to evaluate macular areas within, bordering and beyond the CMVR lesions. Extralesional retinal capillary plexus of the macula were evaluated by OCT angiography and compared with the unaffected fellow eyes. Thirteen eyes from 13 patients were enrolled. At baseline, macular areas without CMVR lesions showed decreased vessel density (VD) of both the superficial (P = 0.0002) and deep (P < 0.0001) retinal capillary plexus in eyes with CMVR as compared with the corresponding macular areas of the unaffected fellow eyes. The decrease of VD persisted through the follow-up period for up to 12 months after adjusting for degree of vitreous haze. Structural macular OCT characteristics at the borders and beyond the lesions included intraretinal hyperreflective dots, cystoid macular edema, subretinal fluid and selective ellipsoid zone (EZ) loss. The selective EZ loss found in 6 of 12 eyes showed recovery in 4 eyes after receiving anti-viral treatment. In CMVR eyes, there were microvascular and microstructural abnormalities in the macular area without clinically visible CMVR lesions. Our results provided interesting insights into CMV infection of the retina.

Highlights

To evaluate extralesional microvascular and structural changes of the macula using optical coherence tomography angiography (OCTA) and structural OCT in cytomegalovirus retinitis (CMVR)
This study demonstrated the presence of microvascular and microstructural abnormalities in the macular area without visible CMVR lesions on clinical examination in eyes with CMVR
There was a decrease in the vessel density (VD) of both superficial and deep retinal capillary plexus by quantitative OCTA analyses

Summary

Introduction

To evaluate extralesional microvascular and structural changes of the macula using optical coherence tomography angiography (OCTA) and structural OCT in cytomegalovirus retinitis (CMVR). Occlusive retinal vasculitis is evident and association of CMVR with several ischemic retinal vascular diseases was r eported[8,9,10] These pieces of evidence suggest that there could be a global dysfunction of the inner blood retinal barrier or retinal capillary plexus in eyes affected with CMVR. Optical coherence tomography angiography (OCTA) is a recent technology that allows depth-resolved visualization of microvascular blood flow of the macula noninvasively. This opens the opportunity for an in vivo study of the retinal capillary plexus in CMVR eyes in order to provide more understanding of the disease and subsequent therapeutic intervention. Microstructural changes of the macula were investigated using structural optical coherence tomography (OCT)

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