Triple viral retinitis diagnosed by polymerase chain reaction of the vitreous biopsy in a patient with Richter syndrome.

PURPOSE: To report the evaluation and identification of herpes viruses associated with retinitis in a patient with Richter syndrome.

METHODS

Diagnostic vitrectomy was performed on a patient with systemic leukemia and retinitis. The vitreous sample was evaluated by cytology, analysis of cytokines by ELISA, and detection of virus by polymerase chain reaction.

RESULTS

The vitreous biopsy specimen showed no malignant cells but predominant CD8+ lymphocyte infiltration with elevated interferon gamma and interleukin-6. DNA amplification and Southern blot analysis demonstrated DNA of herpes simplex, varicella-zoster, and cytomegalovirus.

CONCLUSION

Retinitis associated with multiple viruses in the vitreous biopsy may mimic leukemic infiltration in the eye.