ArticleJournal of ophthalmic inflammation and infection2026
Ultra-widefield retinal imaging for early detection of asymptomatic cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation: a prospective pilot feasibility study.
Article in Journal of ophthalmic inflammation and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate the feasibility and potential clinical utility of ultra-widefield (UWF) retinal imaging as a screening strategy for the early detection of asymptomatic cytomegalovirus retinitis (CMVR) in patients with systemic cytomegalovirus (CMV) viremia after allogeneic hematopoietic stem cell transplantation (alloHSCT).
methodsThis prospective, single-center pilot study included adult alloHSCT recipients with documented CMV replication within the previous 12 months and no ocular symptoms. Patients underwent UWF retinal imaging (Optomap®) at the time of CMV detection and during follow-up. Demographic, hematologic, immunologic, and virologic data were collected. Retinal images were assessed by a uveitis specialist, and patients with suspected retinal involvement underwent targeted ophthalmologic evaluation and treatment.
resultsThirty-nine alloHSCT recipients (mean age 48.8 years; 51.3% male) were screened using UWF imaging. CMVR was identified in one asymptomatic patient (2.6%), presenting with peripheral retinal periphlebitis and hemorrhages 251 days after alloHSCT. Notably, CMV PCR in peripheral blood was negative at the time of retinal diagnosis, while aqueous humor PCR confirmed CMV infection. Early detection through UWF imaging enabled prompt systemic antiviral therapy, resulting in complete resolution of retinal lesions and preservation of visual acuity.
conclusionsIn this prospective pilot study, UWF retinal imaging proved to be a feasible, non-invasive approach for screening asymptomatic alloHSCT recipients with prior CMV replication. Although the incidence of CMVR was low, UWF imaging allowed detection of early peripheral retinal involvement that would likely have been missed by symptom-based surveillance or blood PCR monitoring alone. These findings support the potential role of targeted UWF screening in selected high-risk patients and justify further evaluation in larger, multicenter prospective studies.
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