Volume : 6, Issue : 11, November - 2017

Case Report : Cytomegalovirus retinitis with occlusive vasculitis in both eyes of immunocompetent male patient

Dr Syeda Tahreemunisa, Dr Sandhya Ramachandra

Abstract :

<p>&nbsp;<b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Purpose</span></b><span style="font-size: 12pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;"> : To report a case of&nbsp; cytomegalovirus retinitis with occlusive vasculitis in both eyes of an immunocompetent male patient.&nbsp;</span></p> <p class="MsoNormal" style="line-height:200%"><b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Methods</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:<b> </b>A 48 year old male patient on treatment for aseptic meningitis presented to the ophthalmology department with sudden bilateral painful diminision of vision. Ophthalmologic examination showed anterior segment inflammation with mild vitreous reaction and focal retinitis patches bilaterally with left eye also showing signs of optic nerve head edema and macular edema. Patient was started on IV and topical steroids(prednisolone). Extensive diagnostic workup was performed including Fluorescein angiography, serology for&nbsp; infectious agents like tuberculosis, HIV and syphilis which were negative.&nbsp; Inspite of treatment , patient s vision was gradually deteriorating when aqueous tap was done and patient was empirically started on injection acyclovir 500 mg TID and later continued with oral steroids and acyclovir. Topical steroids and homatropine was continued. Intravitreal Ranibizumab was given to halt the retinal inflammation. Subsequent follow ups showed resolving retinal inflammation with extensive sclerosis &amp; attenuation of the retinal arteries. <o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Results </span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:&nbsp; Inspite of&nbsp; treatment with high dose iv methylprednisolone, injection acyclovir, &nbsp;topical steroids and Intravitreal lucentis, p<span style="color:#333333">atient had significantly decreased vision&nbsp; due to occlusive vasculitis.</span><o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion:</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> <span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Cytomegalovirus infection can be associated with occlusive vasculopathy in immunocompetent individuals.</span><o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">&nbsp;</span></b></p> <p>&nbsp;</p> <p class="MsoNormal" style="line-height:200%"><b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">&nbsp;</span></b></p> <p class="MsoNormal" style="line-height:200%"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p></o:p></span></p>