Challenges in HIV-Negative Cytomegalovirus Retinitis - case report

Area of Science:

• Ophthalmology
• Immunology
• Infectious Diseases

Background:

• Severe combined immunodeficiency (SCID) is a group of rare genetic disorders.
• SCID patients are highly susceptible to opportunistic infections, including viral infections affecting the eyes.
• Cytomegalovirus (CMV) retinitis can cause significant vision impairment in immunocompromised individuals.

Observation:

• A 20-year-old female with SCID presented with bilateral decreased visual acuity.
• Diagnosis of Cytomegalovirus (CMV) retinitis was confirmed by elevated viral serological levels.
• Initial treatment with oral valganciclovir led to visual improvement from finger counting to 6/12 in the affected eye.

Findings:

• Antiviral therapy with valganciclovir demonstrated efficacy in treating CMV retinitis in an SCID patient.
• Treatment interruption due to financial reasons did not immediately cause ophthalmological deterioration.
• Despite stable ocular status, the patient's systemic condition worsened due to untreated immunodeficiency.

Implications:

• Early diagnosis and treatment of CMV retinitis are crucial for preserving vision in SCID patients.
• The underlying immunodeficiency remains a critical factor influencing the overall prognosis.
• Integrated management addressing both opportunistic infections and the primary immunodeficiency is essential for long-term outcomes.