Bilateral cytomegalovirus panuveitis after high-dose corticosteroid therapy

Area of Science:

• Ophthalmology
• Infectious Diseases
• Virology

Background:

• Cytomegalovirus (CMV) is a common virus that can cause opportunistic infections in immunocompromised individuals.
• Immunosuppressive corticosteroid therapy is frequently used for various medical conditions, increasing the risk of opportunistic infections.
• Ocular involvement, particularly CMV retinitis, is a known complication in immunocompromised patients.

Observation:

• A previously healthy 30-year-old woman developed bilateral CMV panuveitis.
• The patient was receiving immunosuppressive doses of corticosteroids.
• The clinical presentation was atypical, characterized by bilateral exudative detachments with minimal signs of retinitis.

Findings:

• Culture-proved CMV panuveitis was diagnosed.
• The atypical presentation included significant exudative detachments without typical retinitis.
• This suggests CMV can manifest unusually in the eye.

Implications:

• Patients on immunosuppressive corticosteroids and with a history of blood transfusions are at risk for ocular CMV.
• Clinicians should consider CMV infection in the differential diagnosis of atypical uveitis, even with minimal retinitis.
• Early recognition and appropriate management are crucial for visual preservation in such cases.