Cytomegalovirus retinitis after intravitreous triamcinolone injection in a patient with central retinal vein occlusion.
To report a case of cytomegalovirus (CMV) retinitis after intravitreal injection of triamcinolone acetonide (IVTA). A 77-year-old woman with macular edema due to central retinal vein occlusion (CRVO) developed peripheral retinitis 4 months after IVTA. A diagnostic anterior chamber paracentesis was performed to obtain DNA for a polymerase chain reaction (PCR) test for viral retinitis. The PCR test was positive for CMV DNA. Other tests for infective uveitis and immune competence were negative. Four months after presentation, gancyclovir was intravitreously injected a total of 5 times, and the retinitis resolved completely. CMV retinitis is a rare complication of local immunosuppression with IVTA. It can be managed with timely injection of intravitreal gancyclovir until recovery from local immunosuppression.
Park
Yong Sik
YS
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Byeon
Suk Ho
SH
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000235:genetics; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology; D016133:Polymerase Chain Reaction; D012170:Retinal Vein Occlusion / Q000150:complications / Q000188:drug therapy*; D014222:Triamcinolone Acetonide / Q000009:adverse effects*; D014822:Vitreous Body
D000998:Antiviral Agents; D004279:DNA, Viral; D007166:Immunosuppressive Agents; D014222:Triamcinolone Acetonide; D015774:Ganciclovir