Role of retinal vascular endothelial cells in development of CMV retinitis

N. A. Rao, Jie Zhang, S. I. Ishimoto, D. A. Jabs, W. R. Green, J. Pulido

Research output: Contribution to journalArticle

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Abstract

Purpose: Although cytomegalovirus (CMV) retinitis is known to occur in association with retinal microangiopathy in individuals with marked immunodeficiency, glial cells are believed to be the initial target cells in the development of retinitis. Moreover, it has been hypothesized that CMV gains access to the retinal glia because of altered vascular permeability. In an attempt to address the hypothesis, we studied 30 autopsy eyes of AIDS patients with systemic CMV infection, with or without clinically apparent CMV retintis. Methods: The autopsy eyes were processed in three ways. First, dual immunohistochemical studies were done by using anti-CMV antibodies for immediate early, early, and late antigens. The retinal cell types infected with the virus were then determined by using anti-GFAP, anti-VonWillebrand's factor, neuronal specific enolase, and leukocyte marker CD68. Second, selected eyes were processed for in situ hybridization with DNA probe specific to CMV. Third, an eye with clinically apparent CMV retinitis was submitted for electron microscopic examination. Results: At the site of retinal necrosis in those eyes with a clinical diagnosis of CMV retinitis, the immunohistochemical, in situ hybridization, and ultrastructural examinations revealed that CMV was present primarily in the Muller cells and in perivascular glial cells. Adjacent to these infected cells, focal areas of positive staining for CMV antigen were seen in the glial cells, neuronal cells, and retinal pigment epithelial cells. At these sites most of the retinal capillaries were devoid of endothelial cells. Few vessels located at the advancing margin of retinal necrosis showed the presence of viral proteins in the endothelial cells. Conclusions: The present results indicate that retinal vascular endothelial cells could be the initial target in the development of viral retinitis, with subsequent spread of the infection to perivascular glia, Muller cells, and other retinal cells, including the retinal pigment epithelium.

Original languageEnglish (US)
Pages (from-to)111-126
Number of pages16
JournalTransactions of the American Ophthalmological Society
Volume96
StatePublished - Dec 1 1998
Externally publishedYes

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Cytomegalovirus Retinitis
Retinal Vessels
Cytomegalovirus
Neuroglia
Endothelial Cells
Ependymoglial Cells
Retinitis
In Situ Hybridization
Autopsy
Necrosis
Antigens
Retinal Pigments
Phosphopyruvate Hydratase
Retinal Pigment Epithelium
DNA Probes
Cytomegalovirus Infections
Capillary Permeability
Viral Proteins
Anti-Idiotypic Antibodies
Acquired Immunodeficiency Syndrome

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Rao, N. A., Zhang, J., Ishimoto, S. I., Jabs, D. A., Green, W. R., & Pulido, J. (1998). Role of retinal vascular endothelial cells in development of CMV retinitis. Transactions of the American Ophthalmological Society, 96, 111-126.

Role of retinal vascular endothelial cells in development of CMV retinitis. / Rao, N. A.; Zhang, Jie; Ishimoto, S. I.; Jabs, D. A.; Green, W. R.; Pulido, J.

In: Transactions of the American Ophthalmological Society, Vol. 96, 01.12.1998, p. 111-126.

Research output: Contribution to journalArticle

Rao, N. A. ; Zhang, Jie ; Ishimoto, S. I. ; Jabs, D. A. ; Green, W. R. ; Pulido, J. / Role of retinal vascular endothelial cells in development of CMV retinitis. In: Transactions of the American Ophthalmological Society. 1998 ; Vol. 96. pp. 111-126.
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