Cytomegalovirus endotheliitis after fluocinolone acetonide (Retisert) implant in a patient with Behçet uveitis

Ocul Immunol Inflamm. 2011 Aug;19(4):282-3. doi: 10.3109/09273948.2011.580075.

Abstract

Purpose: To report a case of cytomegalovirus (CMV) endotheliitis after insertion of an intravitreal fluocinolone acetonide (Retisert) implant.

Design: Interventional case report.

Methods: Retrospective chart review.

Results: A 40-year-old man received a Retisert implant in the left eye for recurrent Behçet uveitis. Although inflammation became quiescent within a month, corneal edema developed 4 months after insertion. Polymerase chain reaction analysis for aqueous humor detected 3.9 × 10(4) copies/mL of CMV DNA. After treatment with oral valganciclovir, CMV DNA nearly disappeared but visual outcome was poor due to corneal decompensation resulting from severe endothelial cell loss.

Conclusions: After Retisert implant, clinicians should be attentive to the potential risk of CMV endotheliitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • Antiviral Agents / administration & dosage
  • Behcet Syndrome / complications*
  • Corneal Edema / complications
  • Corneal Edema / drug therapy
  • Corneal Edema / virology
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / drug therapy
  • Drug Implants / adverse effects
  • Endothelium, Corneal / virology*
  • Fluocinolone Acetonide / administration & dosage*
  • Ganciclovir / administration & dosage
  • Ganciclovir / analogs & derivatives
  • Humans
  • Inflammation / complications
  • Inflammation / drug therapy
  • Inflammation / virology*
  • Male
  • Uveitis / drug therapy*
  • Uveitis / etiology
  • Valganciclovir
  • Vision Disorders / etiology

Substances

  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Drug Implants
  • Fluocinolone Acetonide
  • Valganciclovir
  • Ganciclovir