Cytomegalovirus Retinitis After Intravitreous Triamcinolone Injection in a Patient with Central Retinal Vein Occlusion

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MeSH: Aged ; Antiviral Agents/therapeutic use ; Cytomegalovirus/genetics ; Cytomegalovirus Retinitis/diagnosis ; Cytomegalovirus Retinitis/drug therapy ; Cytomegalovirus Retinitis/etiology* ; DNA, Viral/analysis ; Female ; Ganciclovir/therapeutic use ; Humans ; Immunosuppressive Agents/adverse effects* ; Injections ; Macular Edema/drug therapy ; Macular Edema/etiology ; Polymerase Chain Reaction ; Retinal Vein Occlusion/complications ; Retinal Vein Occlusion/drug therapy* ; Triamcinolone Acetonide/adverse effects* ; Vitreous Body

Keywords: Cytomegalovirus ; Gancyclovir ; Immunosuppression ; Retinitis ; Triamcinolone

Abstract: To report a case of cytomegalovirus (CMV) retinitis after intravitreal injection of triamcinolone acetonide (IVTA). A 77-year-old woman with macular edema due to central retinal vein occlusion (CRVO) developed peripheral retinitis 4 months after IVTA. A diagnostic anterior chamber paracentesis was performed to obtain DNA for a polymerase chain reaction (PCR) test for viral retinitis. The PCR test was positive for CMV DNA. Other tests for infective uveitis and immune competence were negative. Four months after presentation, gancyclovir was intravitreously injected a total of 5 times, and the retinitis resolved completely. CMV retinitis is a rare complication of local immunosuppression with IVTA. It can be managed with timely injection of intravitreal gancyclovir until recovery from local immunosuppression