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Fanny Varenne1, Aurore Siegfried-Vergnon2, Sébastien Lhomme3,4,5

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JC polyomavirus (JCPyV) can cause a rare form of retinopathy in immunocompromised individuals. This case highlights JCPyV retinopathy as a novel manifestation, emphasizing the need for testing in unexplained retinopathy.

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Area of Science:

  • Ophthalmology
  • Virology
  • Immunology

Background:

  • JC polyomavirus (JCPyV) reactivation in immunocompromised individuals typically leads to progressive multifocal leukoencephalopathy.
  • Ocular manifestations of JCPyV are rare, with limited documented cases.

Purpose of the Study:

  • To report a case of polyomavirus-related retinopathy, a potentially novel manifestation of JCPyV infection.
  • To describe a patient with common variable immunodeficiency (CVID) and isolated unilateral retinopathy due to JCPyV.

Main Methods:

  • Case report of a patient managed at a referral center.
  • Diagnostic procedures included anterior chamber paracentesis for PCR and shotgun metagenome sequencing, and retinal biopsy.
  • Therapeutic intervention involved an intravitreal injection of cidofovir.

Main Results:

  • A 52-year-old male with CVID presented with unilateral progressive retinopathy.
  • JCPyV DNA was identified in anterior chamber fluid via PCR and sequencing.
  • Retinal biopsy confirmed JCPyV infection in retinal ganglion cells.
  • Cidofovir treatment led to transient JCPyV DNA negativity but caused adverse events.

Conclusions:

  • This case expands the known clinical spectrum of JCPyV infection.
  • Retinopathy may be an underappreciated complication of JCPyV in immunocompromised patients.
  • Consider JCPyV testing in immunocompromised patients with unexplained retinopathy.