Cytomegalovirus retinitis in HIV-negative patients
Purpose
To describe clinical characteristics of cytomegalovirus (CMV) retinitis in HIV-negative patients
Methods
Retrospective study including 6 patients (10 eyes) who were HIV-negative and diagnosed with CMV retinitis in the department of Ophthalmology Fattouma Bourguiba University Hospital of Monastir
Results
The mean age of patients was 43 years. Immunodeficiency factors included immunosuppressive treatment after kidney transplant in 2 cases, ulcerative colitis in 2 cases, systemic corticosteroid overdose in 1 case, and chemotherapy for lymphoma in 1 case. The mean initial visual acuity was 20/40. The involvement was bilateral in 80% of cases. The retinitis was fulminant with necrotic-hemorrhagic lesions in 4 eyes and indolent granular without hemorrhage in 6 eyes. Associated signs included anterior uveitis in 4 eyes, mild to moderate vitritis in all cases, optic disc hyperemia in 2 eyes, and multiple retinal arterial branch occlusions in one eye. The diagnosis of CMV retinitis was based on a highly suggestive clinical presentation and confirmed by identification of CMV in aqueous humor for 4 patients and serological tests for 2 patients. All patients were treated with intravenous ganciclovir (for 10 to 15 days). All patients received intravitreal ganciclovir in one eye (eye with more severe involvement in bilateral cases)
Conclusion
The incidence of CMV infection in HIV-negative patients is increasing. Diagnosis of CMV retinitis is clinical. PCR analysis of aqueous or vitreous ocular fluid is indicated in atypical clinical presentations. Visual outcomes may be poor despite aggressive appropriate treatment
Conflict of interest
No
Authors 1
Last name
KHAIRALLAH
Initials of first name(s)
M
Department
Department of Ophthalmology, Tahar Sfar University Hospital
City
Mahdia
Country
Tunisia
Authors 2
Last name
WALHA
Initials of first name(s)
Y
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Authors 3
Last name
KECHIDA
Initials of first name(s)
M
Department
Department of Internal medicine, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Authors 4
Last name
NABI
Initials of first name(s)
W
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Authors 5
Last name
KHOCHTALI
Initials of first name(s)
S
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
Authors 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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