J Korean Ophthalmol Soc > Volume 60(1); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(1):85-90.
DOI: https://doi.org/10.3341/jkos.2019.60.1.85    Published online January 15, 2019.
A Case of Cytomegalovirus Retinitis Following Intravitreal Dexamethasone Implant in an Immunocompetent Patient with Uveitis.
Inhye Kim, Junyeop Lee
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. retina@yu.ac.kr
비감염포도막염 치료로 덱사메타손 임플란트삽입 후 발생한 거대세포바이러스망막염 1예
김인혜⋅이준엽
영남대학교 의과대학 안과학교실
Correspondence:  Junyeop Lee,
Email: retina@yu.ac.kr
Received: 12 July 2018   • Revised: 8 August 2018   • Accepted: 20 December 2018
Abstract
PURPOSE
We report a case of cytomegalovirus (CMV) retinitis following placement of an intravitreal dexamethasone implant in an immunocompetent patient diagnosed with non-infectious uveitis. CASE SUMMARY: A 60-year-old woman was referred to our hospital for recurrent anterior uveitis. Fundus examination and fluorescein angiography showed dense vitritis, but no definite retinal infiltration. After laboratory examinations, the patient was diagnosed with non-infectious panuveitis. Uveitis was much improved after the patient started taking oral steroid medication. However, the patient complained of systemic side effects from the oral steroids. Medication was stopped, and an intravitreal dexamethasone implant was fitted to address worsening inflammation. Two months later, perivascular retinal infiltration developed and vitritis recurred. Viral retinitis was suspected, and the patient underwent diagnostic vitrectomy adjunctive with intravitreal ganciclovir injection. Polymerase chain reaction of vitreous fluid confirmed the diagnosis of CMV retinitis. The patient has remained inflammation-free for more than 20 months after vitrectomy, single ganciclovir injection, and 2 months of oral valganciclovir medication. CONCLUSIONS: This is a case report of CMV retinitis following placement of an intravitreal dexamethasone implant in an immunocompetent patient without any risk factors or previous history of immunosuppression. Potential risk factors for CMV retinitis should be evaluated and careful follow-up should be performed when intravitreal dexamethasone injections are unavoidable for the treatment of non-infectious uveitis.
Key Words: Cytomegalovirus retinitis;Dexamethasone;Ganciclovir;Uveitis;Vitrectomy


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