Cytomegalovirus retinitis following intravitreal triamcinolone acetonide in a patient with chronic uveitis on systemic immunosuppression.

PURPOSE: To report a case of cytomegalovirus (CMV) retinitis in an HIV-negative, iatrogenically immunosuppressed patient with chronic uveitis following intravitreal triamcinolone acetonide (IVTA).

DESIGN

Observational case report.

METHODS

A 56-year-old female with chronic idiopathic panuveitis on azathioprine received a single 4-mg IVTA injection for macular edema and presented after 6 months with severe retinitis.

RESULTS

CMV was confirmed by polymerase chain reaction of vitreous fluid. The retinitis responded well to intravitreal ganciclovir, but she developed a rhegmatogenous retinal detachment and underwent vitrectomy with silicone oil tamponade.

CONCLUSIONS

Sight-threatening CMV retinitis may develop in HIV-negative, immunosuppressed individuals after IVTA. Regular fundoscopy for up to 9 months after IVTA is recommended.