Cytomegalovirus retinitis following intravitreal dexamethasone implant in a patient with central retinal vein occlusion

Cytomegalovirus Retinitis in HIV and Non-HIV Individuals

“…With every increasing indication for immune suppression, CMVR is also presenting more frequently in non-HIV immune suppressed individuals. It is exceedingly rare to observe CMVR in healthy patients unless it is secondary to local ocular steroid treatment [71][72][73][74][75][76].…”

“…CMVR following periocular or intraocular steroid injection has been documented in immunocompetent individuals. CMVR following sub-Tenon triamcinolone injection, intravitreal dexamethasone implant, and fluocinolone acetonide implant in immunocompetent individuals on no other immunosuppression have been reported [71][72][73][74][75][76]. Local immunosuppression following intraocular or periocular steroid may result in reactivation of latent CMV resulting in CMVR [75,76].…”

Acute retinal necrosis and ocular neovascularization caused by cytomegalovirus following intravitreal dexamethasone implant (Ozurdex®) in an immunocompetent patient

“…Secondly, viral retinitis may represent an underreported and/or unrecognised risk of Ozurdex administration. To our knowledge, there are only four reports, including our own, of viral retinitis following Ozurdex treatment (Ozturk et al 2014;Kucukevcilioglu et al 2015;Vannozzi et al 2016). Conversely, intravitreal triamcinolone has been associated with a 0.41% incidence of viral retinitis in large systematic case series (Shah et al 2010).…”

“…ous reports have highlighted that otherwise immunocompetent patients can develop CMV or other types of viral retinitis in the context of subtenonial or intravitreal triamcinolone(Shah et al 2010;Takakura et al 2014). Recently,Vannozzi et al (2016) reported a case of CMV retinitis following the use of a dexamethasone implant (Ozurdex; Allergan Inc., Irvine, CA, USA). However, their patient was also on systemic immunosuppression with mycophenolate mofetil.…”

Cytomegalovirus Retinitis in the Post-cART Era

“…Viral titers correlate with disease activity and may be used to distinguish between active and inactive retinitis [54]. PCR testing has been used to definitively diagnose CMVR in cases of local immunosuppression from steroid injection or implant [55–57]. PCR testing may also be used to identify viral resistance to antiviral medications and may thus help guide therapy [58].…”