Clinical Characteristics, Risk Factors and Prognostic Factors of Cytomegalovirus Retinitis After Hematopoietic Stem Cell Transplantation.

PURPOSE: To investigate the clinical characteristics, risk factors, and prognostic factors of cytomegalovirus retinitis (CMVR) after hematopoietic stem cell transplantation (HSCT).

METHODS

A retrospective cohort study was conducted involving 473 HSCT patients (193 allogeneic, 280 autologous) from 2019 to 2023.

RESULTS

In this cohort, 12 patients (21 eyes) developed CMVR. The cumulative incidence was 2.54%. CMVR was bilateral in 75% of cases, with a mean onset of 136.4 ± 59.1 days post-transplantation. CMV DNA was detected in 88.9% (16/18) of aqueous humor samples. Retinal detachment was the most common complication, affecting 52.4% of eyes. All patients had three or more risk factors. Median visual acuity declined from 20/80 (range, hand motion-20/20) initially to 20/125 (range, no light perception-20/25) at final follow-up. CMVR was the first symptom of CMV infection in 16.7% of cases. The recurrence rate was 25.00% (3/12), with recurrent cases linked to EBV viremia episodes. Correlation analysis revealed that CMVR type and initial BCVA were significantly associated with RD (p < 0.05).

CONCLUSIONS

These findings highlight the critical importance of the first year post-HSCT for CMVR detection. Increased ophthalmic screening is advised for patients with multiple risk factors and hemorrhagic types to improve outcomes.