title: Spontaneous resolution of intravitreal steroid-induced bilateral cytomegalovirus retinitis.
abstract: A 73-year-old woman underwent vitrectomy and intravitreal triamcinolone acetonide (IVTA) of the right eye and cataract surgery with IVTA of the left eye, for bilateral diabetic macular edema. The patient presented with visual loss in both eyes three-months postoperatively. The fundoscopic examination revealed white-yellow, necrotic peripheral lesions in the superotemporal quadrant of both eyes. Although bilateral acute retinal necrosis was suspected, azotemia resulting from diabetic nephropathy limited the use of acyclovir. Antiviral treatment was not started. A sample of the aqueous humor for polymerase chain reaction (PCR) analysis was obtained. One week later, the PCR results indicated the presence of cytomegalovirus (CMV). Since the retinal lesions did not progress and did not threaten the macula, the patient was followed without treatment for CMV. The retinal lesions progressively regressed and completely resolved in both eyes by six months of follow-up. Patients with IVTA-induced CMV retinitis may not require systemic treatment with ganciclovir.
authors.affiliation: Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Won Bin
authors.initials: WB
authors.lastname: Cho
authors.forename: Hyung Chan
authors.initials: HC
authors.lastname: Kim
authors.forename: Jun Woong
authors.initials: JW
authors.lastname: Moon
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D017726:Cytomegalovirus Retinitis / Q000209:etiology*; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D009894:Opportunistic Infections / Q000209:etiology*; D012075:Remission, Spontaneous; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D014821:Vitrectomy
chemical_list: D013256:Steroids; D014222:Triamcinolone Acetonide