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CYTOMEGALOVIRUS RETINITIS IN NON-HIV IMMUNOCOMPROMISED INDIVIDUALS ON TOFACITINIB FOR RHEUMATOID ARTHRITIS
Meghan J Smith1, Jennifer I Lim, Felix Y Chau
1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL.
Retinal Cases & Brief Reports
|March 4, 2026
Summary
Two rheumatoid arthritis patients developed cytomegalovirus (CMV) retinitis while on tofacitinib. This highlights the risk of infectious retinitis in patients treated with Janus kinase inhibitors for autoimmune conditions.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Tofacitinib is a Janus kinase (JAK) inhibitor used to treat RA.
- Immunosuppression increases the risk of opportunistic infections.
Purpose of the Study:
- To report two cases of cytomegalovirus (CMV) retinitis in patients with RA treated with tofacitinib.
- To raise awareness of potential infectious complications associated with JAK inhibitor therapy.
Main Methods:
- Retrospective case series.
- Clinical data review of two patients diagnosed with CMV retinitis.
- Ophthalmological examination and laboratory testing including aqueous PCR for CMV.
Main Results:
- Two elderly women with RA on tofacitinib developed CMV retinitis.
- Patients presented with visual disturbances and characteristic retinal lesions.
- CMV DNA was detected in aqueous humor, confirming the diagnosis in non-HIV individuals.
Conclusions:
- Cytomegalovirus retinitis can occur in non-HIV patients treated with JAK inhibitors like tofacitinib.
- Clinicians should consider infectious retinitis in patients with autoimmune diseases on immunosuppressive therapy.
- Awareness of this risk is crucial for timely diagnosis and management.
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