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Published on: July 23, 2016
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.
Purpose:
To report a case of unilateral cytomegalovirus (CMV) panuveitis with occlusive vasculitis after injection of intravitreal dexamethasone implant in a patient with type 2 diabetes mellitus.
Methods:
Observational case report.
Results:
A 60-year-old immunocompetent man with well-controlled type 2 diabetes mellitus was treated with intravitreal dexamethasone implant for recurrent uveitis that was responsive to steroids. Three months after implantation, the patient develops panuveitis with occlusive vasculitis. Anterior chamber tap confirms diagnosis of cytomegalovirus retinitis. Intravitreal foscarnet and oral valganciclovir led to quiescent disease.
Conclusions:
Patients treated with local immunosuppressants should be monitored carefully to assess treatment response and complications, even in the absence of frank immunodeficiency. Quantitative viral PCR can be an effective way to monitor treatment response to antiviral therapy.
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