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Chorioretinitis with retinal ablation complications in patients with cytomegalovirus infections and high myopia: a case report

  • Thedius Watu ,
  • I Gusti Made Ayu Juliari ,
  • I Made Agus Kusumadjaja ,
  • Ida Ayu Ari Pramita ,


Abstract

Background: Chorioretinitis is uveitis that causes choroidal and retinal inflammation. Chorioretinitis in general due to cytomegalovirus (CMV) infection has been recognized as a major cause of congenital virus infections. A common complication in patients with uveitis is retinal detachment. In addition, high myopia can also cause retinal detachment.

Case Illustration: We reported a 33-year-old male patient who came with chief complaints of a sudden blurred left eye the couple of weeks before admission. The patient had a history of high myopia -5D in both eyes and was HIV positive. One week before the complaint, patient underwent laser therapy because of retinal detachment and was also given Neomicin and Potassium Iodide eye drops. Patients presented with vision 1/60. In funduscopy examination, we found vasculitis, retinal detachment, bleeding and exudate. The patient was then diagnosed with OS Rhegmatogenous Retinal Detachment (RRD) caused by CMV chorioretinitis and high myopia ODS. The patient was treated with valganciclovir 1x900mg, methylprednisolone 2x32mg, prednisone eye drops 6x1 OD and underwent pars plana vitrectomy (VPP). The patient had complicated cataracts, therefore phacoemulsification, evacuation and reinjection of silicon oil and endolaser were performed. Unfortunately, the results obtained are not optimal where the patient's vision becomes the patient's no light perception (NLP).

Discussion: Retinal detachment is a frequent complication in patients with CMV chorioretinitis. The main therapy is HAART, anti-CMV and operative management. This therapy regimen is proven to improve overall patients’ prognosis.

Conclusion: Early diagnosis and appropriate treatment have a very important role in determining the prognosis of patients with CMV chorioretinitis.

Keywords: Chorioretinitis cytomegalovirus retinal detachment high myopia.

References

  1. Geetha R, Tripathy K. Chorioretinitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://pubmed.ncbi.nlm.nih.gov/31869169/
  2. Ghekiere S, Allegaert K, Cossey V, Van Ranst M, Cassiman C, Casteels I. Ophthalmological Findings in Congenital Cytomegalovirus Infection: When to Screen, When to Treat? J Pediatr Ophthalmol Strabismus. 2012;49(5):274–82. Available from: http://dx.doi.org/10.3928/01913913-20120710-03
  3. Swanson EC, Schleiss MR. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North Am. 2013;60(2):335–49. Available from: https://pubmed.ncbi.nlm.nih.gov/23481104
  4. De Hoog J, Ten Berge JC, Groen F, Rothova A. Rhegmatogenous retinal detachment in uveitis. J Ophthalmic Inflamm Infect. 2017;7(1):22. Available from: https://pubmed.ncbi.nlm.nih.gov/29164419
  5. Atlas of Retinal Detachment [Internet]. Springer Singapore; 2018. Available from: http://dx.doi.org/10.1007/978-981-10-8231-3
  6. Craighead JE. Enteric Viral Disease [Internet]. Pathology and Pathogenesis of Human Viral Disease. Elsevier; 2000. p. 431–40. Available from: http://dx.doi.org/10.1016/b978-012195160-3/50033-9
  7. Mandelcorn ED. Infectious causes of posterior uveitis. Can J Ophthalmol. 2013;48(1):31–9. Available from: http://dx.doi.org/10.1016/j.jcjo.2012.11.013
  8. Ruiz-Moreno J, Ruiz-Medrano J, Flores-Moreno I. Retinal and Choroidal Thickness in High Myopia [Internet]. Anterior and Posterior Segment OCT: Current Technology and Future Applications. Jaypee Brothers Medical Publishers (P) Ltd.; 2014. p. 208. Available from: http://dx.doi.org/10.5005/jp/books/12001_23
  9. Sugar EA, Jabs DA, Ahuja A, Thorne JE, Danis RP, Meinert CL, et al. Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol. 2012/02/04. 2012;153(6):1016-24.e5. Available from: https://pubmed.ncbi.nlm.nih.gov/22310076
  10. Singh R, Bhalekar S, Parchand S, Sharma A, Gupta V, Dogra MR, et al. Outcome of surgery in post-cytomegalovirus retinal detachment: experience before and in the era of highly active anti-retroviral therapy in Indian eyes. Indian J Ophthalmol. 2013;61(11):636–9. Available from: https://pubmed.ncbi.nlm.nih.gov/24145573
  11. Gupta MP, Coombs P, Prockop SE, Hasan AA, Doubrovina E, O’Reilly RJ, et al. Treatment of cytomegalovirus retinitis with cytomegalovirus-specific T-lymphocyte infusion. Ophthalmic Surg Lasers Imaging Retina. 2015;46(1):80–2. Available from: https://pubmed.ncbi.nlm.nih.gov/25559515
  12. Biron KK. Antiviral drugs for cytomegalovirus diseases. Antiviral Res. 2006;71(2–3):154–63. Available from: http://dx.doi.org/10.1016/j.antiviral.2006.05.002
  13. Wong JX, Wong EP, Teoh SC. Outcomes of cytomegalovirus retinitis-related retinal detachment surgery in acquired immunodeficiency syndrome patients in an Asian population. BMC Ophthalmol. 2014;14:150. Available from: https://pubmed.ncbi.nlm.nih.gov/25429876
  14. Naithani P, Puranik S, Vashisht N, Khanduja S, Kumar S, Garg S. Role Of Topical Nepafenac In Prevention And Treatment Of Macular Edema After Vitreoretinal Surgery. Retina. 2012;32(2):250–5. Available from: http://dx.doi.org/10.1097/iae.0b013e31821e2057
  15. Kim DY, Jo J, Joe SG, Kim J-G, Yoon YH, Lee JY. Comparison Of Visual Prognosis And Clinical Features Of Cytomegalovirus Retinitis In Hiv And Non-Hiv Patients. Retina. 2017;37(2):376–81. Available from: http://dx.doi.org/10.1097/iae.0000000000001144
  16. Jabs DA, Ahuja A, Van Natta ML, Lyon AT, Yeh S, Danis R, et al. Long-term Outcomes of Cytomegalovirus Retinitis in the Era of Modern Antiretroviral Therapy: Results from a United States Cohort. Ophthalmology. 2015/04/17. 2015;122(7):1452–63. Available from: https://pubmed.ncbi.nlm.nih.gov/25892019

How to Cite

Watu, T., Juliari, I. G. M. A., Kusumadjaja, I. M. A., & Pramita, I. A. A. (2021). Chorioretinitis with retinal ablation complications in patients with cytomegalovirus infections and high myopia: a case report. Intisari Sains Medis, 12(3), 958–962. https://doi.org/10.15562/ism.v12i3.1182
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Thedius Watu
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I Gusti Made Ayu Juliari
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I Made Agus Kusumadjaja
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Ida Ayu Ari Pramita
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