Cytomegalovirus retinitis following intravitreal injection of triamcinolone: report of two cases.
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.
Delyfer
Marie-Noëlle
MN
Vitreo-Retinal Unit, Department of Ophthalmology, Bordeaux Univeristy Hospital, Bordeaux, France. marie.noelle.delyfer@chu-bordeaux.fr
Rougier
Marie-Bénédicte
MB
Hubschman
Jean-Pierre
JP
Aouizérate
Franck
F
Korobelnik
Jean-François
JF
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
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide