Bilateral Concomitant Infection of Cytomegalovirus and Varicella-Zoster Virus Retinitis in an Immunocompromised Adult

Purpose: To report a novel case of bilateral concomitant cytomegalovirus (CMV) retinitis and acute retinal necrosis (ARN) due to varicella-zoster virus (VZV) in an immunocompromised adult. Methods: A case report was evaluated. Results: A 36-year-old immunocompromised man presented with acute painful vision loss in the left eye. On initial presentation, uncorrected distance visual acuity was 20/20 in the right eye and counting fingers at 3 feet (≈1 m), which deteriorated to no light perception (NLP) in the left eye. Fundus examination showed necrotizing retinitis in both eyes, with features of both CMV retinitis and ARN. One week after initiation of antiviral treatment, the patient's uncorrected distance visual acuity remained 20/20 in the right eye and improved from NLP to hand motions at 3 feet (≈1 m) in the left eye. Conclusions: VZV and CMV DNA were detected in the aqueous of a patient with bilateral concomitant CMV and VZV retinitis.