Cytomegalovirus retinitis: an unusual presentation as vitreous hemorrhage.
OBJECTIVE
The purpose of this report is to describe an unusual presentation of vitreous hemorrhage (VH) in a patient with an immunosuppressive condition.


METHODS
Retrospective case report.


RESULTS
A 72-year-old woman with known T-cell prolymphocytic leukemia treated with a course of alemtuzumab presented to our department with a VH in her left eye after a fall. An initial diagnosis of hemorrhagic posterior vitreous detachment was made. However, as the VH was resolving, she was found to have underlying vitritis, occlusive vasculitis, and a pale optic nerve head. Vitreous biopsy confirmed cytomegalovirus retinitis. Despite treatment with intravenous foscarnet and oral valganciclovir, her vision continued to remain poor because of the severe damage from the retinal vasculitis and residual VH.


CONCLUSIONS
As indications for immunosuppression increase, the incidence of cytomegalovirus retinitis in non-HIV-immunosuppressed patients is expected to rise. Therefore, in this subgroup of patients, we should be aware of any underlying retinitis especially in cases with an unusual presentation of VH.
Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom.
Soon Wai
SW
Ch'ng
Alexander
A
Brent
Somnath
S
Banerjee
D000368:Aged; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D015461:Leukemia, Prolymphocytic, T-Cell / Q000150:complications; D012189:Retrospective Studies; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology*