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Elias Adjadj, Matthieu Robert, Caroline Seghir, Sebastien Heritier, Barham Bodaghi, Jean Louis Dufier, Olivier Roche; Treatment Of Herpers Viral Retinopathies In Babies With Severe Immune Deficiency. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2789.
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© ARVO (1962-2015); The Authors (2016-present)
Although retinal and cerebral viral infection by CMV and VZV are common in AIDS patients, they are quite infrequent in patients with other causes of immune deficits. We present a small series of 5 patients with congenital severe congenital immune deficit treated with a bone marrow graft and who presented a CMV or VZV retinitis. We also present the treatment they benefited.
Retrospective study of 8 eyes of 5 patients treated between November 1st 2010 and November 15th 2011. All presented a congenital immune deficit treated by bone marrow graft and were diagnosed with a viral retinitis. The fundus examination was organised when a leukocoria was discovered or when a viral encephalitis was discovered. As soon as the diagnosed was made, an exam under general anesthesia was performed with an anterior chamber puncture and a intra vitreous injection of either Gancyclovir or Foscarnet. Patients were controlled each week and the injection repeated until the viral replication declined
No adverse effects were observed following the procedure. All the retinitis regressed. In 7 eyes, a fibrous scar taking the macula was observed. The 8th eye was diagnosed with an early lesion which regressed with no scar. Two patients presented a bilateral retinal detachment within the month following the last injection.
The prognostic of CMV or VZV retinopathies is poor. A quick and intensive treatment may lessen retinal damages. Intra vitreous injection allow to reach an effective dose quickly and safely.
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