Triple viral retinitis diagnosed by polymerase chain reaction of the vitreous biopsy in a patient with Richter syndrome.
OBJECTIVE
To report the evaluation and identification of herpes viruses associated with retinitis in a patient with Richter syndrome.


METHODS
Diagnostic vitrectomy was performed on a patient with systemic leukemia and retinitis. The vitreous sample was evaluated by cytology, analysis of cytokines by ELISA, and detection of virus by polymerase chain reaction.


RESULTS
The vitreous biopsy specimen showed no malignant cells but predominant CD8+ lymphocyte infiltration with elevated interferon gamma and interleukin-6. DNA amplification and Southern blot analysis demonstrated DNA of herpes simplex, varicella-zoster, and cytomegalovirus.


CONCLUSIONS
Retinitis associated with multiple viruses in the vitreous biopsy may mimic leukemic infiltration in the eye.
Levinson
R D
RD
Eye Associates of New Mexico and Southwest Colorado, Albuquerque 87102, USA.
Hooks
J J
JJ
Wang
Y
Y
Chiu
M T
MT
Kellaway
J
J
Chan
C C
CC
D001706:Biopsy; D015139:Blotting, Southern; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D006561:Herpes Simplex / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D006563:Herpes Zoster Ophthalmicus / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D013577:Syndrome; D014822:Vitreous Body / Q000378:metabolism / Q000473:pathology* / Q000821:virology
D004279:DNA, Viral; D015850:Interleukin-6; D007371:Interferon-gamma