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International consensuses and guidelines on diagnosing and managing cytomegalovirus (CMV) retinitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)

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机构： [1]Department of Ophthalmology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan [2]Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan [3]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China [4]Beijing GIANTMED Medical Diagnostics Lab, Beijing, China [5]Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China [6]Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore [7]Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore [8]Singapore Eye Research Institute, Singapore [9]Duke-NUS Medical School, National University of Singapore, Singapore [10]Singapore National Eye Center, Singapore [11]Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore [12]Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA [13]Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand [14]Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India [15]Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy [16]Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, Australia [17]Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia [18]Department of Ophthalmology, Institute of Vision Research & Severance Eye Hospital, Yonsei University College of Medicine, Seoul, South Korea [19]Vitreoretinal Services, Aditya Jyot Eye Hospital, Mumbai, Maharashtra, India [20]Department of Ophthalmology, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India [21]Kamala Sundaram Foundation, Dharavi, Mumbai, India [22]Public Health Ophthalmology, Sundaram Natarajan Blind Free India Foundation, Chennai, India, [23]Department of Ophthalmology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education and Research, (Deemed to be University), Porur, Chennai, India [24]Umai Universidad Maimónides, Maimonides University, Buenos Aires, Argentina [25]Department of Ophthalmology, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia [26]Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands [27]Department of Ophthalmology, Asian Hospital and Medical Center, Muntinlupa City, Philippines [28]Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand [29]Center of Excellence in Retina, Department of Ophthalmology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand [30]Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan [31]Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China [32]Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China [33]Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, Beijing, China [34]Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China [35]Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, China [36]The Primasia International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China [37]The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [38]Eye Department, C+ Health CKJ (Shenzhen) Hospital, Luohu, Shenzhen, China [39]The C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China

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关键词： cytomegalovirus retinitis controversy consensus guidelines APVRS AAPPO APSOII

摘要：

With the paradigm changes in antiviral therapy, there are a myriad of emerging controversies in the management of cytomegalovirus retinitis (CMVR). A certain extent of variability exists in the management of CMVR among clinical practices worldwide. Hence, alignment in the management strategy is important towards optimizing the care of CMVR. An international panel of experts (IPE) formulated consensus statements for CMVR regarding to its 1) diagnosis, 2) screening, 3) treatment, 4) management in special populations and 5) emerging technologies. The clinical diagnosis of CMVR relies on patient's susceptibility due to compromised immune function and characteristic fundus manifestations. Polymerase chain reaction (PCR) of intraocular fluid for detection of CMV is indicated when confirmation is necessary. Oral valganciclovir is the preferred first-line treatment, and intravitreal ganciclovir injection when CMVR threatens to involve the posterior pole. Cessation of maintenance treatment can be considered after 6 months when CMVR remains inactive with immune reconstitution. Immune recovery uveitis (IRU) must be distinguished from CMVR relapse. Screening is recommended for high risk cases. Utilization of telemedicine and artificial intelligence-aided interpretation will help to alleviate the resources required for CMVR screening. Evidence for novel antiviral and immunotherapy have been appraised as second-line treatment options.Copyright © 2025. Published by Elsevier Inc.

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出版当年[2025]版：

大类 | 2 区医学

小类 | 2 区眼科学

最新[2025]版：

大类 | 2 区医学

小类 | 2 区眼科学

第一作者：

第一作者机构： [1]Department of Ophthalmology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan [2]Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan

通讯作者：

通讯机构： [3]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China [36]The Primasia International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China [37]The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [38]Eye Department, C+ Health CKJ (Shenzhen) Hospital, Luohu, Shenzhen, China [39]The C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China

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International consensuses and guidelines on diagnosing and managing cytomegalovirus (CMV) retinitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)

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