Clinical Characteristics, Risk Factors and Prognostic Factors of Cytomegalovirus Retinitis After Hematopoietic Stem Cell Transplantation

PURPOSE: To investigate the clinical characteristics, risk factors, and prognostic factors of cytomegalovirus retinitis (CMVR) after hematopoietic stem cell transplantation (HSCT). METHODS: A retrospective cohort study was conducted involving 473 HSCT patients (193 allogeneic, 280 autologous) from 2019 to 2023. RESULTS: In this cohort, 12 patients (21 eyes) developed CMVR. The cumulative incidence was 2.54%. CMVR was bilateral in 75% of cases, with a mean onset of 136.4 ± 59.1 days post-transplantation. CMV DNA was detected in 88.9% (16/18) of aqueous humor samples. Retinal detachment was the most common complication, affecting 52.4% of eyes. All patients had three or more risk factors. Median visual acuity declined from 20/80 (range, hand motion-20/20) initially to 20/125 (range, no light perception-20/25) at final follow-up. CMVR was the first symptom of CMV infection in 16.7% of cases. The recurrence rate was 25.00% (3/12), with recurrent cases linked to EBV viremia episodes. Correlation analysis revealed that CMVR type and initial BCVA were significantly associated with RD (p < 0.05). CONCLUSIONS: These findings highlight the critical importance of the first year post-HSCT for CMVR detection. Increased ophthalmic screening is advised for patients with multiple risk factors and hemorrhagic types to improve outcomes.