Management of recurrent macular edema complicating an immune recovery uveitis following a fulminant cytomegalovirus retinitis: A case report
Purpose
To describe a case of immune recovery uveitis secondary to cytomegalovirus retinitis complicated by a recurrent macular edema treated with several periocular injections of triamcinolone acetonide (TA), intravitreal ganciclovir injection and pars plana vitrectomy.
Methods
Single interventional case report
Results
A 37-year-old male patient with acquired immunodeficiency syndrome was diagnosed with a cytomegalovirus retinitis on the right eye (RE) treated initially with intravenous ganciclovir with a good recovery. His best corrected visual acuity (BCVA) was 20/63 on the RE and 20/20 on the left eye (LE). Three months later he presented with a progressive vision loss and his BCVA was counting fingers in his RE and 20/20 on the left eye. The examination revealed the presence of an intermediate uveitis with peripheral scars and no active retinal infiltrate. The diagnosis of an inflammatory macular edema complicating an immune recovery uveitis was made and he received two (three months separate) periocular injections of TA and an intravitreal injection of ganciclovir without any anatomical and functional improvement. We performed a pars plana vitrectomy. At one year of follow up we noticed no recurrence of the macular edema but visual acuity remains at counting fingers.
Conclusion
Cytomegalovirus could lead to challenging sight threatening complications. Pars plana vitrectomy could be considered earlier in the management of the macular edema.
Conflict of interest
No
Authors 1
Last name
MAAMOURI
Initials of first name(s)
Rym
Department
ophthalmology
City
Tunis
Country
Tunisia
Authors 2
Last name
Nafaa Fehmi
Initials of first name(s)
F
Department
ophthalmology
City
Tunis
Country
Tunisia
Authors 3
Last name
Halouani
Initials of first name(s)
Safa
Department
ophthalmology
City
Tunis
Country
Tunisia
Authors 4
Last name
Ouederni Meriem
Initials of first name(s)
M
Department
ophthalmology
City
Tunis
Country
Tunisia
Authors 5
Last name
Cheour Monia
Initials of first name(s)
M
Department
ophthalmology
City
Tunis
Country
Tunisia
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