Advertisement

International Ophthalmology

, Volume 29, Issue 2, pp 85–90 | Cite as

Acute retinal necrosis by cytomegalovirus in an immunocompetent adult: case report and review of the literature

  • I. TajunisahEmail author
  • S. C. Reddy
  • L. H. Tan
Case Report

Abstract

A rare case of acute retinal necrosis caused by cytomegalovirus in an immunocompetent adult, diagnosed by polymerase chain reaction of vitreous aspirate, with good visual outcome after intravitreal and intravenous ganciclovir and oral prednisolone therapy, is reported. A 50-year-old healthy lady presented with redness and diminution of vision in her right eye of 10 days duration. She had anterior chamber inflammation, marked vitritis, and anterior retinal necrosis in the right eye. Blood and other investigations did not reveal any infectious diseases and HIV testing was negative. The retinal lesions and panuveitis resolved with treatment. Two months later she developed retinal detachment which was treated successfully. The best-corrected vision was 6/12 in the right eye. Seven cases of cytomegalovirus ocular infection in immunocompetent healthy adults, reported in the literature, were reviewed. The different presentations of this disease and the importance of suspecting this causative agent are highlighted.

Keywords

Cytomegalovirus Acute retinal necrosis Ganciclovir Polymerase chain reaction 

References

  1. 1.
    Cohen JI, Corey GR (1985) Cytomegalovirus infection in the normal host. Medicine 64:100–112PubMedCrossRefGoogle Scholar
  2. 2.
    Urayama A, Yamada N, Sasaki T (1971) Unilateral acute uveitis with retinal periarteritis and detachment. Jpn J Ophthalmol 25:607–19Google Scholar
  3. 3.
    Chawla HB, Ford MJ, Munro JF et al (1976) Ocular involvement in a cytomegalovirus infection in a previously healthy adult. BMJ 2:281–282PubMedCrossRefGoogle Scholar
  4. 4.
    England AC III, Miller SA, Maki DG (1982) Ocular findings of acute cytomegalovirus infection in an immunologically competent adult. N Engl J Med 307:94–95PubMedCrossRefGoogle Scholar
  5. 5.
    Lopez-Contreras J, Ris J, Domingo P, Puig M, Rabella N, Nolla J (1995) Disseminated cytomegalovirus infection in an immunocompetent adult successfully treated with ganciclovir. Scand J Infect Dis 27:523–525PubMedCrossRefGoogle Scholar
  6. 6.
    Silverstein BE, Conrad D, Margolis TP, Wong IG (1997) Cytomegalovirus-associated acute retinal necrosis syndrome. Am J Ophthalmol 123:257–258PubMedGoogle Scholar
  7. 7.
    Saidel MA, Berreen J, Margolis TP (2005) Cytomegalovirus retinitis after intravitreous triamcinolone in an immunocompetent patient. Am J Ophthalmol 140:1141–1143PubMedCrossRefGoogle Scholar
  8. 8.
    Stewart MW, Bolling JP, Mendez JC (2005) Cytomegalovirus retinitis in an immunocompetent patient. Arch Ophthalmol 123:572–574PubMedCrossRefGoogle Scholar
  9. 9.
    Voros GM, Pandit R, Snow M, Griffiths PG (2006) Unilateral recurrent acute retinal necrosis syndrome caused by cytomegalovirus in an immune-competent adult. Eur J Ophthalmol 16:484–486PubMedGoogle Scholar
  10. 10.
    Delyfer MN, Rougier MB, Hubschman JP, Aouizerate F, Korobelnik JF (2007) Cytomegalovirus retinitis following intravitreal injections of triamcinolone: report of two cases. Acta Ophthalmol Scand 85:681–683PubMedCrossRefGoogle Scholar
  11. 11.
    Tran THC, Rozenberg F, Cassoux N, Rao NA, LeHoang P, Bodaghi B (2003) Polymerase chain reaction analysis of aqueous humour samples in necrotizing retinitis. Br J Ophthalmol 87:79–83PubMedCrossRefGoogle Scholar
  12. 12.
    Fox GM, Crouse CA, Chuang EL et al (1991) Detection of herpesvirus DNA in vitreous and aqueous specimens by the polymerase chain reaction. Arch Ophthalmol 109:266–271PubMedGoogle Scholar
  13. 13.
    McCann JD, Margolis TP, Wong MG et al (1995) A sensitive and specific polymerase chain reaction-based assay for the diagnosis of cytomegalovirus retinitis. Am J Ophthalmol 120:219–226PubMedGoogle Scholar
  14. 14.
    Holland G (1994) Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society. Am J Ophthalmol 117:663–667PubMedGoogle Scholar
  15. 15.
    Clarkson JG, Blumenkranz MS, Culbertson WW et al (1984) Retinal detachment following the acute retinal necrosis syndrome. Ophthalmology 91:1665–1668PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.Department of Ophthalmology, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  2. 2.Department of Medicine (Infectious Diseases), Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia

Personalised recommendations