Cytomegalovirus retinitis after fluocinolone acetonide (Retisert) implant

Am J Ophthalmol. 2007 Feb;143(2):334-5. doi: 10.1016/j.ajo.2006.09.020. Epub 2006 Oct 23.

Abstract

Purpose: To report a case of cytomegalovirus (CMV) retinitis after placement of a fluocinolone acetonide (Retisert) implant.

Design: Interventional case report.

Methods: Retrospective chart review.

Results: A 65-year-old man with a history of Adamantiades-Behcet disease and bilateral recurrent uveitis that was unresponsive to systemic corticosteroid-sparing immunosuppressive therapy developed clinical evidence of CMV retinitis after receiving his second intravitreal Retisert implant in the left eye, while on no systemic immunosuppression. He did not develop CMV retinitis in the right eye despite multiple intraocular and periocular steroid injections. The patient responded well to intravitreal foscarnet followed by placement of an intravitreal ganciclovir implant.

Conclusions: Ophthalmologists should be aware of the potential risk for development of CMV retinitis after local ocular immunosuppressive therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use
  • Behcet Syndrome / complications
  • Cytomegalovirus Retinitis / diagnosis
  • Cytomegalovirus Retinitis / drug therapy
  • Cytomegalovirus Retinitis / etiology*
  • Drug Implants
  • Fluocinolone Acetonide / administration & dosage
  • Fluocinolone Acetonide / adverse effects*
  • Foscarnet / therapeutic use
  • Ganciclovir / therapeutic use
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Humans
  • Immunocompromised Host
  • Macular Edema / drug therapy
  • Male
  • Retrospective Studies
  • Uveitis / complications

Substances

  • Antiviral Agents
  • Drug Implants
  • Glucocorticoids
  • Fluocinolone Acetonide
  • Foscarnet
  • Ganciclovir