Cytomegalovirus acute retinal necrosis in an immunocompetent patient after sub-tenon triamcinolone injection.
OBJECTIVE
To report a case of cytomegalovirus acute retinal necrosis after a sub-Tenon injection of triamcinolone acetonide in an immunocompetent patient.


METHODS
A 77-year-old man received a sub-Tenon injection of triamcinolone acetonide for treatment of iritis unresponsive to topical steroids. He subsequently developed unilateral acute retinal necrosis.


RESULTS
Vitreous biopsy with polymerase chain reaction analysis was positive for cytomegalovirus. Implantation of a sustained-release ganciclovir device resulted in disease stabilization.


CONCLUSIONS
Cytomegalovirus can be a causative agent of both anterior uveitis and acute retinal necrosis. A potential complication of a sub-Tenon steroid injection may be viral reactivation causing acute retinal necrosis secondary to localized immunosuppression.
From the Department of Ophthalmology, Rush University, Chicago, Illinois.
Amy S
AS
Babiuch
Zac B
ZB
Ravage
Pauline T
PT
Merrill