title: Cytomegalovirus retinitis following intravitreal injection of triamcinolone: report of two cases.
abstract: BACKGROUND
  Cytomegalovirus (CMV) retinitis usually affects severely immunosuppressed individuals. However, some exceptional and isolated cases of CMV retinitis have been described in immunocompetent patients.
  
  
  METHODS
  We report two cases of non-immunodeficient patients seen in our institution over a period of 6 months, who presented with CMV retinitis a few weeks after an intravitreal injection of triamcinolone acetonide.
  
  
  RESULTS
  Although the cellular and molecular mechanisms underlying the development of CMV in an immunocompetent patient's eye have not yet been precisely established, the well known immunosuppressive properties of corticosteroids suggest that triamcinolone probably plays a role in the endogenous reactivation of latent CMV.
  
  
  CONCLUSIONS
  Our two patients received high doses of triamcinolone. Both had also pseudophakia, vitrectomy and a past medical history of type 2 diabetes mellitus. Such features, individually or combined, may be risk factors for local reactivation of CMV and should be considered prior to the administration of triamcinolone acetonide in ophthalmology.
authors.affiliation: Vitreo-Retinal Unit, Department of Ophthalmology, Bordeaux Univeristy Hospital, Bordeaux, France. marie.noelle.delyfer@chu-bordeaux.fr
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Delyfer
authors.forename: Marie-Bénédicte
authors.initials: MB
authors.lastname: Rougier
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Hubschman
authors.forename: Franck
authors.initials: F
authors.lastname: Aouizérate
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Korobelnik
mesh_terms: D000368:Aged; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008297:Male; D019591:Pseudophakia / Q000150:complications; D014222:Triamcinolone Acetonide / Q000009:adverse effects*; D014775:Virus Activation; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide