Predictors of cytomegalovirus corneal endotheliitis postcorneal transplantation

IF 3.7 2区 医学 Q1 OPHTHALMOLOGY British Journal of Ophthalmology Pub Date : 2024-12-22 DOI:10.1136/bjo-2024-326055
Mako Watanabe, Koji Kitazawa, Hideki Fukuoka, Koichi Wakimasu, Tsutomu Inatomi, Kengo Yoshii, Noriko Koizumi, Shigeru Kinoshita, Chie Sotozono
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Abstract

Purpose This study was designed to investigate risk factors for the development of cytomegalovirus (CMV) corneal endotheliitis following corneal transplantation. Methods We retrospectively analysed 1225 corneal transplants for bullous keratopathy between 2011 and 2021. 31 cases who were administered the treatment of CMV corneal endotheliitis preoperatively were excluded, and 1194 cases were analysed for risk factors for the development of CMV corneal endotheliitis following corneal transplantation. Results Among 1194 cases, 15 cases (1.26%) occurred CMV corneal endotheliitis after corneal transplantation. Coin-shaped lesion or keratoprecipitates were observed in 100% of cases. Postoperatively, the mean onset of CMV corneal endotheliitis was 9.9±12.2 months, with 12 eyes (80.0%) within the first 12 months. Multivariate analysis adjusted for potential confounding factors revealed a gender (male, OR (8.42, 95% CI: 2.19 to 56.00), the previous history of anterior uveitis (OR: 25.31, 95% CI: 8.22 to 95.19) and the previous history of glaucoma (OR: 6.25, 95% CI: 1.17 to 115.90) were significantly associated with the development of postoperative CMV corneal endotheliitis. The maternal proportion Ryan multiple comparison tests revealed that dual previous history with glaucoma and anterior uveitis significantly enhanced the development of postoperative CMV corneal endotheliitis (p<0.001). Conclusions CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis. Data are available upon reasonable request. The data that support the findings of this study are available from Kyoto Prefectural University of Medicine upon reasonable request.
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角膜移植后巨细胞病毒角膜内皮炎的预测因素
目的探讨角膜移植术后发生巨细胞病毒(CMV)角膜内皮炎的危险因素。方法回顾性分析2011年至2021年间1225例大疱性角膜病变的角膜移植。排除31例术前接受巨细胞病毒性角膜内皮炎治疗的患者,分析1194例角膜移植术后发生巨细胞病毒性角膜内皮炎的危险因素。结果1194例患者中,角膜移植术后发生巨细胞病毒性角膜内皮炎15例(1.26%)。所有病例均有硬币状病变或角膜沉淀。术后CMV角膜内皮炎的平均发病时间为9.9±12.2个月,前12个月内12只眼(80.0%)。校正潜在混杂因素的多因素分析显示,性别(男性,OR (8.42, 95% CI: 2.19 ~ 56.00)、既往葡萄膜前炎史(OR: 25.31, 95% CI: 8.22 ~ 95.19)和既往青光眼史(OR: 6.25, 95% CI: 1.17 ~ 115.90)与术后CMV角膜内皮炎的发生显著相关。母体比例Ryan多重比较检验显示,青光眼和前葡萄膜炎双重病史显著增加术后CMV角膜内皮炎的发生(p<0.001)。结论巨细胞病毒性角膜内皮炎发生于角膜移植后,病变呈硬币状。对于有青光眼或前葡萄膜炎病史的患者,术后随访十分必要,尤其是术后12个月内。如有合理要求,可提供资料。支持本研究结果的数据可应合理要求从京都立医科大学获得。
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来源期刊
CiteScore
10.30
自引率
2.40%
发文量
213
审稿时长
3-6 weeks
期刊介绍: The British Journal of Ophthalmology (BJO) is an international peer-reviewed journal for ophthalmologists and visual science specialists. BJO publishes clinical investigations, clinical observations, and clinically relevant laboratory investigations related to ophthalmology. It also provides major reviews and also publishes manuscripts covering regional issues in a global context.
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