Author (year) | Age (years) | Gender | Unilateral (U) or bilateral (BL) | Timing of CMV retinitis relative to thymoma diagnosis (months) | Associated opportunistic infectionsa | Zone (involved)b | Retinitis treatmentc | CMV testing | Vision when retinitis was first diagnosed | Follow-up (months) | Vision at the last visit | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Previously published cases | Ho et al. (2010) [10] | 68 | M | U | 75 months after thymoma | Recurrent pneumonia; disseminated CMV; CMV colitis | Zone I | IV ganciclovir and then PO valganciclovir | Lung biopsy | 20/200 | 1 | 20/100 |
Mateo-Montoya et al. (2010) [11] | 57 | M | U | NR. “Long time after thymoma” | Recurrent pneumonia; Camplyobacter sepsis | Zone I | IVT ganciclovir, IVT foscarnet, and IV ganciclovir then PO valganciclovir | Aqueous PCR; vitreous PCR | 20/100 | 6 | 20/40 | |
Park et al. (2009) [12] | 56 | M | BL | 3 months after thymoma | NR | Zone I and zone II | IVT ganciclovir and IV ganciclovir, then PO valganciclovir | Aqueous PCR; serum IgG | 20/800 OD, 20/125 OS | 6 | CF at 30 cm OD, NLP OS | |
Sen et al. (2005)1 [13] | 48 | M | U | 60 months after thymoma | Pneumocystis jiroveci pneumonia; history of retinitis and optic neuropathy | Zone I | IVT ganciclovir and IVT ganciclovir implant (Vitrasert) | Aqueous PCR | 20/200 | 7 | 20/200 | |
Wan et al. (2012) [14] | 51 | F | U | 60 months after thymoma | Recurrent sinopulomary infections; CMV enterocolitis | Zone II | PO valganciclovir then IVT ganciclovir weekly | Vitreous PCR | 20/40 | 6 | 20/50 then subsequently to CF due to the development of autoimmune retinopathy | |
Yong et al. (2008) [15] | 50 | F | U | 6 months after thymoma | Herpes zoster (T10 dermatome) | NR | IV ganciclovir, then PO valganciclovir | Vitreous PCR | NR | 2 | NLP | |
Assi et al. (2002) [16] case 1 | 45 | F | U | 24 months after thymoma | Recurrent pneumonia; zoster dermatitis | Zone II and zone III | IV valaciclovir, then IVT ganciclovir implant | Vitreous PCR | 20/40 | 6 weeks | NR | |
Assi et al. (2002) [16] case 2 | 65 | F | U | 24 months after thymoma | Recurrent pneumonia | Zone I | IVT foscarnet then PO ganciclovir | Vitreous PCR | HM | NR | HM | |
Current case | Downes, et al. (2016) | 65 | F | U | 1 month before thymoma | Oropharyngeal candidiasis; Candida esophagitis; pneumonia | Zone II and zone III | IVT ganciclovir, then PO valganciclovir | Aqueous PCR | 20/100 | 7 | 20/80 |
Summary | Total n = 9 | Mean: 56 years | Male: 4/9 (44.4 %) | 8/9 (88.9 %) unilateral | Retinitis diagnosed after thymoma: 8/9 (88.9 %) | Respiratory infections: 7/9 (77.8 %) | Zone I: 5/8 reported (62.5 %) | Intravitreal therapy alone: 1/9 (11.1 %) | Positive aqueous PCR: 4/9 (44.4 %) | Acuity better than 20/40: 0/9 eyes (0.0 %) | Mean = 4.56 months | Acuity better than 20/40: 0/9 eyes (0.0 %) |
Median: 56 years | Female: 5/9 (55.5 %) | Mean = 31.4 months after thymoma | Non-ocular CMV: 2/9 (22.2 %) | Zone II: 4/8 reported (50 %) | Systemic therapy alone: 2/9 (22.2 %) | Positive vitreous PCR: 5/9 (55.5 %) | Acuity between 20/40 and 20/200: 7/9 eyes (77.8 %) | Median = 6 months | Acuity between 20/40 and 20/200: 5/9 eyes (55.5 %) | |||
Range: 48–68 years | Male to female ratio 0.8:1 | Median = 24 months after thymoma | Other opportunistic infections: 3/9 (33.3 %) | Zone III: 2/8 reported (25 %) | Combo intravitreal and systemic therapy: 6/9 (66.6 %) | Confirmed by other means: 1/9 (11.1 %) | Acuity worse than 20/200: 2/9 eyes (22.2 %) | Range = 1.5–7 months | Acuity worse than 20/200: 4/9 eyes (44.4 %) | |||
Range = 75 months after to 1 month before |