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Cytomegalovirus retinitis and FK 506
Antonio P Ciardella1, Gaetano Barile, Kevin Langton
1Department of Ophthalmology, Edward S. Harkness Eye Institute, New York Presbyterian Hospital, New York, New York 10032, USA. aciardella@yahoo.com
Purpose:
To report a case of cytomegalovirus (CMV) retinitis in a patient immunosuppressed with FK 506.
Design:
Interventional case report.
Methods:
Retrospective institutional study. One patient, diagnosed with bilateral CMV retinitis while on immunosuppressive treatment with FK 506, received systemic ganciclovir and intravitreal, slow-release ganciclovir implant in one eye, combined with reduction in FK 506 dose. Main outcome measures were visual acuity and regression of CMV retinitis.
Results:
Visual acuity at presentation was 20/20 in the right eye and 20/50 in the left eye. During the 6 months of follow-up, there was no change in visual acuity in either eye. The areas of CMV retinitis demonstrated progressive regression, leaving diffuse retinal atrophy.
Conclusions:
Cytomegalovirus retinitis can be a sight-threatening complication of immunosuppressive treatment with FK 506. Ganciclovir treatment together with a reduction in FK 506 dose was effective in preserving vision.