Cytomegalovirus anterior uveitis and occlusive retinal vasculitis without retinitis in a patient on immunomodulatory therapy.

IF 2.9 Q1 OPHTHALMOLOGY Journal of Ophthalmic Inflammation and Infection Pub Date : 2023-08-04 DOI:10.1186/s12348-023-00356-z

Lorenzo Fabozzi, Ilaria Testi, Laura De Benito-Llopis, Carlos Pavesio

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Abstract

Purpose: To describe unusual clinical features and therapeutic management of a case of cytomegalovirus (CMV) ocular disease in a patient on immunomodulatory therapy.

Setting/venue: Moorfields Eye Hospital NHS Foundation Trust, London, UK.

Methods: Medical history, clinical findings, investigation results, and multimodal imaging were retrospectively collected.

Results: A 61-year-old, South-East Asian man, developed CMV-related endotheliitis and occlusive retinal vasculitis, diagnosed by wide-angle fluorescein angiography. No retinitis was present on the fundus examination. Suspicion of CMV etiology was based on anterior segment findings, especially the presence of coin-shaped endothelial lesions. The diagnosis was confirmed by aqueous polymerase chain reaction (PCR) analysis which was positive for CMV DNA. The combined use of topical and systemic valganciclovir resulted in significant improvement of the picture.

Conclusions: CMV can manifest in the eye as occlusive retinal vasculitis without the presence of typical retinitis.

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免疫调节治疗的巨细胞病毒前葡萄膜炎和视网膜闭塞性血管炎1例。

目的:描述一例巨细胞病毒(CMV)眼病患者接受免疫调节治疗的异常临床特征和治疗管理。地点/地点:英国伦敦Moorfields眼科医院NHS基金会信托基金。方法:回顾性收集患者的病史、临床表现、调查结果及多模态影像学资料。结果:一名61岁的东南亚男性，通过广角荧光素血管造影诊断为巨细胞病毒相关的内皮炎和闭塞性视网膜血管炎。眼底检查未见视网膜炎。怀疑巨细胞病毒的病因是基于前段的发现，特别是硬币状内皮病变的存在。经水相聚合酶链反应(PCR)分析证实，CMV DNA阳性。局部和全身联合使用缬更昔洛韦可显著改善图像。结论:巨细胞病毒可以在没有典型视网膜炎的情况下表现为视网膜闭塞性血管炎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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