CMV retinitis after intravitreal triamcinolone acetonide injection in a patient with Behçet's uveitis.
We report the case of a patient with Behçet's uveitis who developed cytomegalovirus (CMV) retinitis after intravitreal triamcinolone acetonide (IVTA) injection. We reviewed the patient's chart for the purpose of this report. An IVTA injection was performed for treatment of severe panuveitis in the left eye of a 30-year-old male patient with Behçet's disease. Systemic treatment included high dose corticosteroid and azathioprine. Fourteen weeks after IVTA, extensive areas of necrotizing retinitis developed in the left eye. Polymerase chain reaction of serum and vitreous samples was positive for CMV DNA. Serum anti-CMV IgG was positive, IgM was negative, anti-HIV antibody was negative, complete blood count was normal, and CD4 count was 1,060 cells/μl. The patient responded well to intravitreal ganciclovir injection performed twice and intravenous ganciclovir treatment administered for five weeks. Local immunosuppression with IVTA may cause CMV retinitis. Awareness of this serious complication is important for correct diagnosis and treatment.
Tugal-Tutkun
Ilknur
I
Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul Tip Fakultesi, Goz Hastaliklari A.D, Capa, 34390, Istanbul, Turkey. itutkun@istanbul.edu.tr
Araz
Bilge
B
Cagatay
Atahan
A
D000328:Adult; D001528:Behcet Syndrome / Q000188:drug therapy*; D017726:Cytomegalovirus Retinitis / Q000209:etiology* / Q000276:immunology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D058449:Intravitreal Injections; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D014222:Triamcinolone Acetonide