Table 1 A brief review of some of the recent reports of CMV retinitis in immunocompetent patients. (Abbreviations: Diabetes mellitus (DM), injection of triamcinolone acetonide (IVTA), central retinal vein occlusion (CRVO))
case (Reference) | Age | Laterality | Systemic and ocular history | Manifestation | Treatment | Initial visual acuity | Final visual acuity |
|---|---|---|---|---|---|---|---|
1 [1] | 61 | Right eye | None | Fine keratic precipitates, 1+ aqueous cells, mild vitritis, patches of hemorrhagic retinitis and perivascular sheathing | Intravitreal ganciclovir followed by oral valganciclovir | 4/20 | 8/20 |
2 [9] | 51 | Both eyes | None | Fine keratic precipitates, 1+ aqueous cell, and flare, 1+ vitritis in both eyes, areas of confluent retinitis and hemorrhage and peripheral necrosis and fibrosis | Oral valganciclovir | 20/60 (right eye) and 20/50 (left eye) | 20/70 (right eye) and 20/60 (left eye) |
3 [5] | 75 | Left eye | Diabetes mellitus (DM), intravitreal injection of triamcinolone acetonide (IVTA) | The rare cell in the anterior chamber, no vitreous cells, arcuate retinal whitening (which appeared full-thickness) along the temporal vascular arcades | Intravitreal ganciclovir followed by oral valganciclovir | 20/80 | 20/400 |
4 [2] | 77 | Right eye | DM, IVTA | Fine keratic precipitates, 2 + vitritis, foci of oedematous retinitis with dense retinal whitening, hemorrhages and inflammatory retinal vascular sheathing | Intravitreal injection of ganciclovir + intravenous administration of ganciclovir followed by oral valganciclovir | counting fingers at 1.8 m | 20/200 |
5 [2] | 69 | Right eye | DM, central retinal vein occlusion (CRVO), Vitrectomy surgery, IVTA | Keratic precipitates, 2 + cells in the anterior chamber, moderate vitritis, necrotizing retinitis extending throughout the entire retina with hemorrhages, retinal opacification and periphlebitis | Intravitreal injection of ganciclovir + intravenous administration of ganciclovir followed by oral valganciclovir | 20/200 | 20/400 |
6 [3] | 54 | Left eye | Carrier of human T-cell lymphotropic virus type 1, DM, CRVO, vitrectomy surgery, IVTA | Small granulomatous keratic precipitates, 1+ aqueous cell and flare, 1+ vitritis, papillitis, retinal vasculitis, and retinal exudates | Intravenous injections of ganciclovir + Intravitreous injections of foscarnet | 1.0 | 0.5 |
7 [10] | 78 | Right eye | IVTA | Keratic precipitates, 2+ cells in the anterior chamber and moderate vitritis, hemorrhagic sheathing of branch arteries, inflammatory vascular sheathings in the periphery and areas of retinal whitening in the peripheral superior nasal part | Intravitreous injections of ganciclovir + intravenous ganciclovir followed by oral valganciclovir | 20/40 | 20/25 |
8 [4] | 61 | Left eye | DM, intravitreal injection of bevacizumab | 4+ cells and in the anterior chamber, dense vitritis and retinal vascular obliteration, necrotizing retinitis with dense retinal whitening and hemorrhage | Intravenous administration of ganciclovir | Hand motions | Not reported |
9 [6] | 75 | Left eye | DM, intravitreal injection of ranibizumab | Mild anterior segment inflammation, low-grade vitritis, and foci of retinitis in the peripheral fundus along with retinal and subretinal hemorrhages, exudates, and macular edema | Intravitreal ganciclovir | 4/10 | 5/10 |
10 [11] | 74 | Right eye | Multiple intraocular surgeries, long-term use of immunosuppressive eye drops such as corticosteroids and cyclosporine | No inflammatory cells in the anterior chamber or the anterior vitreous, confluent exudate the entire peripheral retina | Intravenous ganciclovir+ intravitreal ganciclovir injections followed by oral valganciclovir | Hand motions | Not reported |