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OCCLUSIVE CYTOMEGALOVIRUS PANUVEITIS AFTER INTRAVITREAL DEXAMETHASONE IMPLANT.
Hyun Jun Kim1,2, Daniel Brill1,2, Gian Paolo Giuliari2
1University of Cincinnati College of Medicine, Cincinnati, OH; and.
Retinal Cases & Brief Reports
|February 3, 2023
Summary
A case report highlights cytomegalovirus (CMV) panuveitis and vasculitis in a diabetic patient after a dexamethasone implant. Prompt antiviral treatment led to disease remission, emphasizing careful monitoring post-immunosuppression.
Area of Science:
- Ophthalmology
- Virology
- Immunology
Background:
- Intravitreal corticosteroid injections are used for ocular inflammation.
- Diabetes mellitus can influence ocular health and immune response.
Observation:
- A 60-year-old man with type 2 diabetes developed unilateral cytomegalovirus (CMV) panuveitis with occlusive vasculitis.
- Symptoms appeared three months after receiving an intravitreal dexamethasone implant for recurrent uveitis.
Findings:
- Anterior chamber tap confirmed cytomegalovirus retinitis.
- Treatment with intravitreal foscarnet and oral valganciclovir resulted in disease quiescence.
Implications:
- Careful monitoring for complications is crucial in patients receiving local immunosuppressants, even without overt immunodeficiency.
- Quantitative viral PCR may aid in monitoring antiviral treatment efficacy.
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