Long-term prophylaxis in an immunocompetent patient with Cytomegalovirus retinitis: a case report and review of literature

• Main Authors: Seyed Ali Tabatabaei, Kasra Cheraqpour, Elias Khalili Pour, Bahram Bohrani Sefidan
• Format: Article
• Language: English
• Published: SpringerOpen 2020-06-01
• Series: Journal of Ophthalmic Inflammation and Infection
• Subjects: Cytomegalovirus retinitis; Posterior uveitis; CMV; CMV retinitis in immucocompetent patients; Prevention and control
• Online Access: http://link.springer.com/article/10.1186/s12348-020-00207-1

Abstract Background Cytomegalovirus retinitis is an infectious sight-threatening condition that usually occurs in immunosuppressed individuals, but rare cases of Cytomegalovirus retinitis have been reported in immunocompetent patients. Findings A 68-year-old woman without any history of systemic diseases referred to the emergency ward of Farabi eye hospital with a two-week history of decreased vision in her left eye. Fundoscopy of the left eye revealed mild venous tortuosity, hemorrhagic retinitis within the macula, and papillitis. The right eye had a history of Cytomegalovirus retinitis 2 years ago that complicated with rhegmatogenous retinal detachment. Immunologic evaluations were normal without any sign of immunosuppressive conditions. She was treated with intravenous ganciclovir for 2 weeks, intravitreal ganciclovir (twice weekly) for 1 week, and also daily oral valganciclovir as maintenance therapy for 6 months resulted in resolving of retinitis patches and improving her best-visual acuity from hand motions to 20/100. Forty-five days after stopping maintenance therapy recurrence occurred. So we started the treatment again to stabilize the patient. She is currently maintained on valganciclovir 900 mg daily without recurrence for 9 months. Conclusions Cytomegalovirus retinitis can recur in the same or contralateral eye of immunocompetent patients, especially without prophylactic medication.