AIM:To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newlyonset cytomegalovirus retinitis (CMVR).METHODS...AIM:To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newlyonset cytomegalovirus retinitis (CMVR).METHODS:The retrospective study observed 37 patients(58 eyes) who suffered from CMVR onset between 2013 and 2015. Among them, 35 eyes underwent 4 weekly intravitreal injections of 3.0 mg ganciclovir, and 23 eyes underwent 4 weekly injections of 3.0 mg ganciclovir combined with 2.4 mg foscarnet. Visual acuity, intraocular pressure and viral load of cytomegalovirus (CMV) in aqueous humor measured by real-time polymerase chain reaction were compared before and after each injection.RESULTS:CMV-DNA copies in aqueous humor decreased remarkably in both groups. The average of CMV-DNA copies in patients’ aqueous decreased from 38.3×10~4 copies/mL at baseline to 2.2×10~4 copies/mL after the 4^(th) injection in patients who were treated with ganciclovir monotherapy,and decreased from 76.9×10~4 copies/mL to 11.3×10~4 copies/mL after 4 continuous injections of ganciclovir combined with foscarnet. No significant difference was found in reduction of viral load, change of visual acuities or intraocular pressures between monotherapy or combined therapy.CONCLUSION:Results of this study show that the initial effectiveness of treating CMVR after 4 weekly intravitreal injections is not significantly different from ganciclovir alone or combined with foscarnet. Continuous injection of ganciclovir alone is sufficient in treating immunosuppressive patients with newly-onset CMVR.展开更多
AIM:To compare the clinical manifestation of cytomegalovirus(CMV)retinitis and microvascular retinopathy(MVR)in patients with acquired immunodeficiency syndrome(AIDS)in China.METHODS:A total of 93 consecutive ...AIM:To compare the clinical manifestation of cytomegalovirus(CMV)retinitis and microvascular retinopathy(MVR)in patients with acquired immunodeficiency syndrome(AIDS)in China.METHODS:A total of 93 consecutive patients with AIDS,including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed.Highly active antiretroviral therapy(HAART)status was recorded.HIV and CMV immunoassay were also tested.CD4+T-lymphocyte count and blood CMV-DNA test were performed in all patients.Aqueous humor CMV-DNA test was completed in 39patients.Ophthalmological examinations including best corrected visual acuity(BCVA,by International Standard Vision Chart),intraocular pressure(IOP),slit-lamp biomicroscopy,indirect ophthalmoscopy were performed.RESULTS:In MVR group,the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13.Blood CMV-DNA was 0(0,269 000)and 42 patients(80.77%)did not receive HAART.In CMV retinitis group,13 patients(31.71%)had anterior segment abnormality.The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470(0,1 450 000).Nineteen patients(46.34%)had not received HAART.MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%,respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION:In comparison of CMV,patients with MVR have relatively mild visual function impairment.Careful ophthalmological examination and close follow-up are mandatory,especially for patients who have systemic complications,positive CMV-DNA test and without received HAART.展开更多
The effect of intravitreal ganciclovir injection combined with intravenous infusion on acquired immune deficiency syndrome(AIDS) patients with cytomegalovirus retinitis(CMVR) was investigated. A total of 32 eyes in 23...The effect of intravitreal ganciclovir injection combined with intravenous infusion on acquired immune deficiency syndrome(AIDS) patients with cytomegalovirus retinitis(CMVR) was investigated. A total of 32 eyes in 23 AIDS patients diagnosed as CMVR from 2017 to 2018 were included in the retrospective study. All patients underwent induction therapy by using intravenous drip of the anticytomegalovirus(CMV) agent ganciclovir(5 mg/kg q12 h) combined with intravitreal ganciclovir injection(3 mg/time, 2 times/wk). The visual acuity, fundus photographs, lesion location, and number of intravitreal injections were observed preoperatively and postoperatively. Totally 14 eyes were cured during induction therapy. The number of injections [4.13(2 to 6)] in CMVR patients with peripherally fundus lesions were significantly lower than those with central lesions (4.89(2 to 6))The individualized therapy of intravitreal ganciclovir injections for AIDS patients with CMVR can effectively reduce the numbers of intravitreal injections.展开更多
AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were en...AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were enrolled in the study.Complete ophthalmologic examinations,color fundus photography,SD-OCT and fundus autofluorescence(FAF)were performed for all patients at the first visit and each follow-up visit.Retinal necrosis in CMVR was analyzed on SD-OCT and classified into two types,the typical type and the atypical type.RESULTS:Forty-one eyes of active CMVR and 4 eyes of recurrent CMVR were classified into typical type,and 4 eyes with graying retinal lesion without hemorrhage or only punctate hemorrhage were classified into atypical type.In active stage of CMVR,the retina in typical type was significant thickened with hyperreflective lesion and fullthickness disruption of retinal architecture with enlarged vessel;while in atypical type,the retina was also destroyed in all layers but without thickening or slightly thinned.The choroid,vitreous and retinal vessels were not significantly involved.In healed stage,the retina was thin with destroyed layers in both types.In typical type,FAF showed mottled hypofluorescence mixed with punctuate hyperfluorescence.In atypical type,the retina showed some"cavity"in outer nuclear layer,and FAF showed mild hyperfluorescence.CONCLUSION:SD-OCT show different changes in the retina in typical type and atypical type of CMVR,which should be useful in assisting diagnosis and follow-up management of the disease.展开更多
AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus(CMV) retinitis(CMVR) in HIV-negative patients.METHODS: HIV-negative patients with CMVR were invol...AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus(CMV) retinitis(CMVR) in HIV-negative patients.METHODS: HIV-negative patients with CMVR were involved in this study. Best corrected visual acuity(BCVA), intraocular pressure(IOP), CMV-DNA load in aqueous and/or serum samples, treatment, follow-up time, recurrence and complications were recorded. Ocular characteristics were evaluated by fundus photographs. Association between ocular factors and visual prognosis were analyzed by regression analysis.RESULTS: Twenty-five eyes of 16 patients were included. All 25 eyes underwent intravitreal injections of anti-viral agents. The mean log MAR BCVA improved from 0.94±0.98(0.98-0.78) initially to 0.77±0.73(0.82-0.68) at last visit, but not significantly. After antiviral treatment, the aqueous CMV DNA load significantly reduced to(3.42±1.47)×10~2 copies/m L(P=0.001), compared with(2.51±3.11)×10~5 copies/m L at baseline. Macular involvement(R~2=0.475, P=0.049) and initial visual acuity(R~2=0.475, P=0.017) were significantly associated with the poor visual prognosis(BCVA<20/400). The extent of retinal lesions(R~2=0.064, P=0.04) was significant associated with the risk of recurrence of CMVR.CONCLUSION: Intravitreal injection of anti-viral agents offers a safe and effective treatment for CMVR. Macular involvement and initial visual acuity significantly associate with visual prognosis. The extent of retinal lesions is significantly associated with the recurrence of CMVR. These ocular factors can be used as predictive risk factors for long term visual prognosis in HIV-negative CMVR patients.展开更多
Dear Editor,I am Dr. Feng Hu, from the Department of Ophthalmology of Beijing Tongren Hospital, Beijing, China. I write to present a case report of cytomegalovirus retinitis (CMVR) in Good’s syndrome (GS).GS is an ex...Dear Editor,I am Dr. Feng Hu, from the Department of Ophthalmology of Beijing Tongren Hospital, Beijing, China. I write to present a case report of cytomegalovirus retinitis (CMVR) in Good’s syndrome (GS).GS is an extremely rare primary immune-deficiency syndrome,which consists of simultaneous occurrence of展开更多
Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the p...Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment.展开更多
Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS)...Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4+ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 μg) were performed in 4 eyes (2 patients).Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4+ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×106/L (range,(0-85) × 106/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.展开更多
To the Editor: Infection is one of the causes of death after chemotherapy in children with leukemia. About 20% to 30% acute lymphocytic leukemia (ALL) patients die from infection after chemotherapy.[1] Patients with i...To the Editor: Infection is one of the causes of death after chemotherapy in children with leukemia. About 20% to 30% acute lymphocytic leukemia (ALL) patients die from infection after chemotherapy.[1] Patients with immune deficiency, under chemotherapy, or treated with immunosuppressor are more inclined to be infected with human cytomegalovirus (HCMV) which leads to severe systematic disorders.[2] Cytomegalvirus retinitis (CMVR) is a major sight threatening disease which mainly occurs in patients with immune deficiency and results in blindness if treatment is delayed. The decrease of CD4+ T cells has been related to CMVR in immune deficiency syndrome like AIDS.[3] However, little is known about the relation between the level of T cells with different markers and the onset of CMVR in ALL patients under chemotherapy. Therefore, this study was designed to investigate the diagnostic value of T cells with different markers for cytomegalovirus retinitis after chemotherapy in patients with ALL.展开更多
基金Supported by the 1351 Beijing Chaoyang Talent Training Program(No.CYXX-2017-21)
文摘AIM:To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newlyonset cytomegalovirus retinitis (CMVR).METHODS:The retrospective study observed 37 patients(58 eyes) who suffered from CMVR onset between 2013 and 2015. Among them, 35 eyes underwent 4 weekly intravitreal injections of 3.0 mg ganciclovir, and 23 eyes underwent 4 weekly injections of 3.0 mg ganciclovir combined with 2.4 mg foscarnet. Visual acuity, intraocular pressure and viral load of cytomegalovirus (CMV) in aqueous humor measured by real-time polymerase chain reaction were compared before and after each injection.RESULTS:CMV-DNA copies in aqueous humor decreased remarkably in both groups. The average of CMV-DNA copies in patients’ aqueous decreased from 38.3×10~4 copies/mL at baseline to 2.2×10~4 copies/mL after the 4^(th) injection in patients who were treated with ganciclovir monotherapy,and decreased from 76.9×10~4 copies/mL to 11.3×10~4 copies/mL after 4 continuous injections of ganciclovir combined with foscarnet. No significant difference was found in reduction of viral load, change of visual acuities or intraocular pressures between monotherapy or combined therapy.CONCLUSION:Results of this study show that the initial effectiveness of treating CMVR after 4 weekly intravitreal injections is not significantly different from ganciclovir alone or combined with foscarnet. Continuous injection of ganciclovir alone is sufficient in treating immunosuppressive patients with newly-onset CMVR.
基金Supported by National Natural Science Foundation of China(No.8157089181272981)+2 种基金Beijing Natural Science Foundation(No.7151003)Capital Medical University Fundamental Clinical Research Cooperation Fund(No.16JL73)Beijing Municipal Administration of Hospitals’Ascent Plan(No.DFL20150201)
文摘AIM:To compare the clinical manifestation of cytomegalovirus(CMV)retinitis and microvascular retinopathy(MVR)in patients with acquired immunodeficiency syndrome(AIDS)in China.METHODS:A total of 93 consecutive patients with AIDS,including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed.Highly active antiretroviral therapy(HAART)status was recorded.HIV and CMV immunoassay were also tested.CD4+T-lymphocyte count and blood CMV-DNA test were performed in all patients.Aqueous humor CMV-DNA test was completed in 39patients.Ophthalmological examinations including best corrected visual acuity(BCVA,by International Standard Vision Chart),intraocular pressure(IOP),slit-lamp biomicroscopy,indirect ophthalmoscopy were performed.RESULTS:In MVR group,the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13.Blood CMV-DNA was 0(0,269 000)and 42 patients(80.77%)did not receive HAART.In CMV retinitis group,13 patients(31.71%)had anterior segment abnormality.The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470(0,1 450 000).Nineteen patients(46.34%)had not received HAART.MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%,respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION:In comparison of CMV,patients with MVR have relatively mild visual function impairment.Careful ophthalmological examination and close follow-up are mandatory,especially for patients who have systemic complications,positive CMV-DNA test and without received HAART.
基金Supported by the Open Research Project of Key Laboratory of Capital Medical University (No.2017YKSJ04)Capital Medical University Fundamental Clinical Research Cooperation Fund (No.16JL73)
文摘The effect of intravitreal ganciclovir injection combined with intravenous infusion on acquired immune deficiency syndrome(AIDS) patients with cytomegalovirus retinitis(CMVR) was investigated. A total of 32 eyes in 23 AIDS patients diagnosed as CMVR from 2017 to 2018 were included in the retrospective study. All patients underwent induction therapy by using intravenous drip of the anticytomegalovirus(CMV) agent ganciclovir(5 mg/kg q12 h) combined with intravitreal ganciclovir injection(3 mg/time, 2 times/wk). The visual acuity, fundus photographs, lesion location, and number of intravitreal injections were observed preoperatively and postoperatively. Totally 14 eyes were cured during induction therapy. The number of injections [4.13(2 to 6)] in CMVR patients with peripherally fundus lesions were significantly lower than those with central lesions (4.89(2 to 6))The individualized therapy of intravitreal ganciclovir injections for AIDS patients with CMVR can effectively reduce the numbers of intravitreal injections.
基金Supported by the National Science and Technology Major Project of China during the 13th Five-year plan period(No.2018ZX10302104).
文摘AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were enrolled in the study.Complete ophthalmologic examinations,color fundus photography,SD-OCT and fundus autofluorescence(FAF)were performed for all patients at the first visit and each follow-up visit.Retinal necrosis in CMVR was analyzed on SD-OCT and classified into two types,the typical type and the atypical type.RESULTS:Forty-one eyes of active CMVR and 4 eyes of recurrent CMVR were classified into typical type,and 4 eyes with graying retinal lesion without hemorrhage or only punctate hemorrhage were classified into atypical type.In active stage of CMVR,the retina in typical type was significant thickened with hyperreflective lesion and fullthickness disruption of retinal architecture with enlarged vessel;while in atypical type,the retina was also destroyed in all layers but without thickening or slightly thinned.The choroid,vitreous and retinal vessels were not significantly involved.In healed stage,the retina was thin with destroyed layers in both types.In typical type,FAF showed mottled hypofluorescence mixed with punctuate hyperfluorescence.In atypical type,the retina showed some"cavity"in outer nuclear layer,and FAF showed mild hyperfluorescence.CONCLUSION:SD-OCT show different changes in the retina in typical type and atypical type of CMVR,which should be useful in assisting diagnosis and follow-up management of the disease.
基金Supported by National Natural Science Foundation of China(No.82070948)Beijing Talent Project(No.2020027)Shunyi District“Beijing Science and Technology Achievements Transformation Coordination and Service Platform”Construction Fund(No.SYGX202010)。
文摘AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus(CMV) retinitis(CMVR) in HIV-negative patients.METHODS: HIV-negative patients with CMVR were involved in this study. Best corrected visual acuity(BCVA), intraocular pressure(IOP), CMV-DNA load in aqueous and/or serum samples, treatment, follow-up time, recurrence and complications were recorded. Ocular characteristics were evaluated by fundus photographs. Association between ocular factors and visual prognosis were analyzed by regression analysis.RESULTS: Twenty-five eyes of 16 patients were included. All 25 eyes underwent intravitreal injections of anti-viral agents. The mean log MAR BCVA improved from 0.94±0.98(0.98-0.78) initially to 0.77±0.73(0.82-0.68) at last visit, but not significantly. After antiviral treatment, the aqueous CMV DNA load significantly reduced to(3.42±1.47)×10~2 copies/m L(P=0.001), compared with(2.51±3.11)×10~5 copies/m L at baseline. Macular involvement(R~2=0.475, P=0.049) and initial visual acuity(R~2=0.475, P=0.017) were significantly associated with the poor visual prognosis(BCVA<20/400). The extent of retinal lesions(R~2=0.064, P=0.04) was significant associated with the risk of recurrence of CMVR.CONCLUSION: Intravitreal injection of anti-viral agents offers a safe and effective treatment for CMVR. Macular involvement and initial visual acuity significantly associate with visual prognosis. The extent of retinal lesions is significantly associated with the recurrence of CMVR. These ocular factors can be used as predictive risk factors for long term visual prognosis in HIV-negative CMVR patients.
基金Supported by the Capital Health Research and Development of Special(No.SF-2018-2-1081)
文摘Dear Editor,I am Dr. Feng Hu, from the Department of Ophthalmology of Beijing Tongren Hospital, Beijing, China. I write to present a case report of cytomegalovirus retinitis (CMVR) in Good’s syndrome (GS).GS is an extremely rare primary immune-deficiency syndrome,which consists of simultaneous occurrence of
基金supported by the National Eye Institute/National Institutes of Health core grant P30-EY06360(Department of Ophthalmology,Emory University School of Medicine)National Eye Institute,National Institutes of Health R01 EY029594(Yeh)and K23 EY030158(Shantha)+1 种基金Funding support was also provided via an Unrestricted Grant from Research to Prevent Blindness(Emory Eye Center,Emory University School of Medicine)Research support has also been provided by the Association for Research in Vision and Ophthalmology Mallinckrodt Award and the Stanley M.Truhlsen Family Foundation,Inc.
文摘Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment.
文摘Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4+ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 μg) were performed in 4 eyes (2 patients).Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4+ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×106/L (range,(0-85) × 106/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.
文摘To the Editor: Infection is one of the causes of death after chemotherapy in children with leukemia. About 20% to 30% acute lymphocytic leukemia (ALL) patients die from infection after chemotherapy.[1] Patients with immune deficiency, under chemotherapy, or treated with immunosuppressor are more inclined to be infected with human cytomegalovirus (HCMV) which leads to severe systematic disorders.[2] Cytomegalvirus retinitis (CMVR) is a major sight threatening disease which mainly occurs in patients with immune deficiency and results in blindness if treatment is delayed. The decrease of CD4+ T cells has been related to CMVR in immune deficiency syndrome like AIDS.[3] However, little is known about the relation between the level of T cells with different markers and the onset of CMVR in ALL patients under chemotherapy. Therefore, this study was designed to investigate the diagnostic value of T cells with different markers for cytomegalovirus retinitis after chemotherapy in patients with ALL.