MULTIMODAL IMAGING OF CHOROIDAL LESIONS IN DISSEMINATED MYCOBACTERIUM CHIMAERA INFECTION AFTER CARDIOTHORACIC SURGERY

被引：14

作者：

Boni, Christian ^{[1
]}

Al-Sheikh, Mayss ^{[1
]}

Hasse, Barbara ^{[2
]}

Eberhard, Roman ^{[1
]}

Kohler, Philipp ^{[2
,3
]}

Hasler, Pascal ^{[4
]}

Erb, Stefan ^{[5
]}

Hoffmann, Matthias ^{[3
]}

Barthelmes, Daniel ^{[1
,6
]}

Zweifel, Sandrine A. ^{[1
]}

机构：

[1] Univ Zurich, Dept Ophthalmol, Univ Hosp Zurich, Zurich, Switzerland

[2] Univ Zurich, Div Infect Dis & Hosp Epidemiol, Univ Hosp Zurich, Zurich, Switzerland

[3] Cantonal Hosp St Gallen, Div Infect Dis & Hosp Epidemiol, St Gallen, Switzerland

[4] Univ Basel, Univ Hosp Basel, Dept Ophthalmol, Basel, Switzerland

[5] Univ Basel, Univ Hosp Basel, Div Infect Dis & Hosp Epidemiol, Basel, Switzerland

[6] Univ Sydney, Save Sight Inst, Sydney, NSW, Australia

来源：

RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES | 2019年 / 39卷 / 03期

关键词：

spectral domain optical coherence tomography; fundus autofluorescence; multifocal choroiditis; choroidal tubercles; granulomatous choroiditis; nontuberculous mycobacterial infection; Mycobacterium chimaera; mycobacterium avium complex; cardiac surgery; MULTIFOCAL CHOROIDITIS; NEOVASCULARIZATION; MANIFESTATION; TUBERCULOSIS; ANGIOGRAPHY; UNITS;

D O I：

10.1097/IAE.0000000000001991

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

Purpose: To explore morphologic characteristics of choroidal lesions in patients with disseminated Mycobacterium chimaera infection subsequent to open-heart surgery. Methods: Nine patients (18 eyes) with systemic M. chimaera infection were reviewed. Activity of choroidal lesions were evaluated using biomicroscopy, fundus autofluorescence, enhanced depth imaging optical coherence tomography, fluorescein angiography/indocyanine green angiography, and optical coherence tomography angiography. Relationships of choroidal findings to systemic disease activity were sought. Results: All 9 male patients, aged between 49 and 66 years, were diagnosed with endocarditis and/or aortic graft infection. Mean follow-up was 17.6 months. Four patients had only inactive lesions (mild disease). In all five patients (10 eyes) with progressive ocular disease, indocyanine green angiography was superior to other tests for revealing new lesions and active lesions correlated with hyporeflective choroidal areas on enhanced depth imaging optical coherence tomography. One eye with a large choroidal granuloma developed choroidal neovascularization. Optical coherence tomography angiography showed areas with reduced perfusion at the inner choroid. All 5 patients with progressive ocular disease had evidence of systemic disease activity within +/- 6 weeks' duration. Conclusion: Choroidal manifestation of disseminated M. chimaera infection indicates systemic disease activity. Multimodal imaging is suitable to recognize progressive ocular disease. We propose ophthalmologic screening examinations for patients with M. chimaera infection.

引用

页码：452 / 464

页数：13