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Cytomegalovirus retinitis following dexamethasone intravitreal implant

Sarah G Chaudhry1, Adrian T Fung1,2,3

  • 1Westmead Hospital, Westmead, Sydney, New South Wales, Australia.

American Journal of Ophthalmology Case Reports
|March 18, 2021
PubMed

Insights

Dexamethasone intravitreal implants can trigger Cytomegalovirus (CMV) retinitis in immunocompetent individuals. Prompt treatment with antivirals led to vision improvement and resolution of CMV retinitis in a case study.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Retinal Diseases

Background:

  • Dexamethasone intravitreal implant (DII) is used for various ocular conditions.
  • Cytomegalovirus (CMV) retinitis typically affects immunocompromised individuals.
  • The potential for DII to induce CMV retinitis in immunocompetent patients is not well-established.

Observation:

  • An 80-year-old immunocompetent male developed CMV retinitis 10 weeks post-DII.
  • Presentation included severe vision loss (20/1200) and panuveitis.
  • Diagnosis confirmed via vitreous biopsy.

Findings:

  • The patient received intravitreal foscarnet and oral valganciclovir.
  • Vision improved to 20/200.
  • CMV retinitis resolved completely following treatment.

Implications:

  • Dexamethasone intravitreal implants may precipitate CMV retinitis in immunocompetent hosts.
  • Ophthalmologists should consider CMV retinitis in patients with unexplained uveitis after DII.
  • Early diagnosis and antiviral therapy are crucial for visual recovery.
Abstract

Keywords:
Cytomegalovirus (CMV)Dexamethasone intravitreal implant (DII)ImmunocompetentRetinitis

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