Case Report

Cytomegalovirus Retinitis in an Immunocompetent Patient: A Case Report

Abstract

A 25-year-old female known case of end-stage renal disease was admitted with chief complaints of headache, dizziness, and vomiting after undergoing her last dialysis seven days prior to her admission and gradual vision loss from 2 days after the onset of her headache. Ocular examination on admission revealed white conjunctiva in the left eye without a pupillary response to light. The ophthalmologic evaluation showed severe retinitis with no fundus change in the left eye. The high intraocular pressure was documented on multiple occasions reaching a peak of 45 mm/Hg. Based on the imaging of the left eye and the clinical presentation of retinitis, the patient was diagnosed with Cytomegalovirus (CMV) retinitis.

Radwan A, Metzinger JL, Hinkle DM, Foster CS. Cytomegalovirus retinitis in immunocompetent patients: case reports and literature review. Ocular immunology and inflammation. 2013;21(4):324-8.

Bae SH, Kim TW, Chung H, Heo JW. Cytomegalovirus retinitis after intravitreal bevacizumab injection in an immunocompetent patient. Korean journal of ophthalmology : KJO. 2013;27(1):61-3.

Ausayakhun S, Skalet AH, Jirawison C, Ausayakhun S, Keenan JD, Khouri C, et al. Accuracy and reliability of telemedicine for diagnosis of cytomegalovirus retinitis. American journal of ophthalmology. 2011;152(6):1053-8.e1.

Yamamoto Y, Kato Y, Tabuchi H, Fukushima A. Case of cytomegalovirus retinitis aggravated by sub-Tenon injection of triamcinolone acetonide with subsequent metastatic liver cancer. Clinical ophthalmology (Auckland, NZ). 2013;7:411-5.

Ljungman P, Griffiths P, Paya C. Definitions of cytomegalovirus infection and disease in transplant recipients. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2002;34(8):1094-7.

Sekiryu T, Iida T, Kaneko H, Saito M. Cytomegalovirus retinitis after intravitreal triamcinolone acetonide in an immunocompetent patient. Japanese journal of ophthalmology. 2008;52(5):414-6.

Toyokawa N, Kimura H, Kuroda S. Cytomegalovirus retinitis after subtenon triamcinolone acetonide and intravitreal injection of anti-vascular endothelial growth factor in an immunocompetent patient with age-related macular degeneration and diabetes mellitus. Japanese journal of ophthalmology. 2010;54(2):166-8.

Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, et al. Aspects of immune dysfunction in end-stage renal disease. Clinical journal of the American Society of Nephrology : CJASN. 2008;3(5):1526-33.

Furukawa M, Kumagai K, Ogino N, Okinami S, Uemura A, Larson E. Cytomegalovirus retinitis after intravitreous triamcinolone treatment of a vitrectomized eye in an immunocompetent patient. Retinal cases & brief reports. 2007;1(4):205-7.

Davis JL, Haft P, Hartley K. Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV. Journal of ophthalmic inflammation and infection. 2013;3(1):17.

Saidel MA, Berreen J, Margolis TP. Cytomegalovirus retinitis after intravitreous triamcinolone in an immunocompetent patient. American journal of ophthalmology. 2005;140(6):1141-3.

Hsu J, Chen E, Vander JF. Cytomegalovirus retinitis after treatment with intravitreal triamcinolone acetonide in an immunocompetent patient. Retinal cases & brief reports. 2007;1(4):208-10.

Delyfer MN, Rougier MB, Hubschman JP, Aouizerate F, Korobelnik JF. Cytomegalovirus retinitis following intravitreal injection of triamcinolone: report of two cases. Acta ophthalmologica Scandinavica. 2007;85(6):681-3.

Park Y-S, Byeon SH. Cytomegalovirus retinitis after intravitreous triamcinolone injection in a patient with central retinal vein occlusion. Korean Journal of Ophthalmology. 2008;22(2):143-4.

Vertes D, Snyers B, De Potter P. Cytomegalovirus retinitis after low-dose intravitreous triamcinolone acetonide in an immunocompetent patient: a warning for the widespread use of intravitreous corticosteroids. International ophthalmology. 2010;30(5):595-7.

Toriyama K, Suzuki T, Hara Y, Ohashi Y. Cytomegalovirus retinitis after multiple ocular surgeries in an immunocompetent patient. Case reports in ophthalmology. 2012;3(3):356-9.

Schneider EW, Elner SG, van Kuijk FJ, Goldberg N, Lieberman RM, Eliott D, et al. Chronic retinal necrosis: cytomegalovirus necrotizing retinitis associated with panretinal vasculopathy in non-HIV patients. Retina (Philadelphia, Pa). 2013;33(9):1791-9.

Takayama K, Ogawa M, Mochizuki M, Takeuchi M. Cytomegalovirus retinitis in a patient with proliferative diabetes retinopathy. Ocular immunology and inflammation. 2013;21(3):225-6.

Karkhaneh R, Lashay A, Ahmadraji A. Cytomegalovirus retinitis in an immunocompetent patient: A case report. Journal of Current Ophthalmology. 2016.

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IssueVol 56, No 9 (2018) QRcode
SectionCase Report(s)
Keywords
Cytomegalovirus Retinitis Immunocompetent

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How to Cite
1.
Arasteh P, Eghbali T, Azimi A. Cytomegalovirus Retinitis in an Immunocompetent Patient: A Case Report. Acta Med Iran. 2018;56(9):613-616.