Original Paper

Asymptomatic Cytomegalovirus Retinitis after Cardiac Transplantation
Tansu Erakgun^a, Filiz Afrashi^a, Sanem Nalbantgil^b, Mustafa Ozbaran^b, Jale Mentes<sup>a

a</sup>Department of Ophthalmology and
^bDepartment of Cardiovascular Surgery, Ege University Hospital, Izmir, Turkey

Address of Corresponding Author

Ophthalmologica 2003;217:446-450 (DOI: 10.1159/000073078)

  Key Words

• Cytomegalovirus retinitis
• Cardiac transplantation

  Abstract

Purpose: To determine the prevalence and the risk factors of cytomegalovirus (CMV) retinitis after cardiac transplantation in visually asymptomatic patients. Methods: Ophthalmoscopic examinations including fundus fluorescein angiography were performed in asymptomatic patients who had cardiac transplantation at Ege University Hospital between April 1998 and June 2002 to screen for evidence of diagnostic CMV retinitis lesions to determine the prevalence in this population. Results: Thirteen patients (aged 40 ± 12.6) who had cardiac transplantation underwent ophthalmoscopic examination 2-50 months (23.5 ± 16.2 months; mean ± SD) after transplantation. All recipients had positive serology to CMV before transplantation. During the study period, 3 patients developed asymptomatic CMV reactivation. One patient developed CMV disease (pneumonia). All of the patients were visually asymptomatic during the study period. Two patients (15%) had a history of diabetes mellitus and chronic severe arterial hypertension. Seven recipients (53%) had been heavy cigarette smokers and 3 patients (23%) had hyperlipidemia. Two (15%) of 13 patients with arterial hypertension and diabetes had evidence of asymptomatic active CMV retinitis. These patients were treated with intravenous ganciclovir. Conclusions: Active cytomegalovirus retinitis lesions were found in 2 (15%) of 13 cardiac transplantation patients who had no visual symptoms. We think that the patients with systemic microvascular risk factors such as diabetes, hypertension and smoking should be screened closely for the development of CMV retinitis after cardiac transplantation even if the patients have no visual symptoms.

Copyright © 2003 S. Karger AG, Basel

  Author Contacts

Dr. Tansu Erakgun
1379 Sok 37/14 Alsancak
TR-35210 Izmir (Turkey)
Tel. +90 232 463 97 01, Fax +90 232 388 14 69
E-Mail erakgun@med.ege.edu.tr

  Article Information

None of the authors has a financial or proprietary interest in the products mentioned in this study.

Received: December 3, 2002
Accepted after revision: May 26, 2003
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 24