Cytomegalovirus retinitis in a patient with Vogt-Koyanagi-Harada disease
Purpose
To report a case of CMV retinitis in a patient with VKH disease.
Methods
Case report
Results
A 33-year-old woman presented with bilateral blurred vision. VKH disease was diagnosed and the patient was prescribed oral prednisolone and azathioprine. The patient mistakingly received four times the prescribed dose of prednisolone for 14 days. The erroneous dose was progressively corrected with subsequent visual acuity improvement, and disappearance of exudative retinal detachments. Three months later, the patient presented with 2+ cells in the vitreous, sunset-glow fundus with diffuse vascular sheathing, and retinal haemorrhages. Systemic corticosteroids and azathioprine were withdrawn. Results of work-up were negative. PCR on aqueous sample was positive for CMV. The patient was given intravenous and intravitreal ganciclovir treatment. CMV retinitis was controlled, but the patient developed a VKH disease recurrence managed with oral prednisolone introduced while the patient was receiving intravenous antiviral treatment.
Conclusion
CMV retinitis may occur in patients with non-infectious uveitis as a consequence of highly systemic immunosuppressive therapy. Both diagnosis and management are challenging.
Conflict of interest
No
Author 1
Last name
ABROUG
Initials of first name(s)
N
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Author 2
Last name
Kkairallah
Initials of first name(s)
M
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Author 3
Last name
Mefteh
Initials of first name(s)
M
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Author 4
Last name
Cherni
Initials of first name(s)
I
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Author 5
Last name
Attia
Initials of first name(s)
S
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Author 6
Last name
Khairallah
Initials of first name(s)
M
Department
Department of ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
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