[Viral retinitis following intravitreal triamcinolone injection].

Abstract

Necrotizing viral retinitis is associated with infection by the Herpes family of viruses, especially herpes simplex virus (HSV), varicella zoster virus (VZV) and occasionally cytomegalovirus (CMV). When the diagnosis is suspected clinically, antiviral therapy must be instituted immediately. We report the case of a patient presenting with necrotizing viral retinitis 3 months following intravitreal injection of triamcinolone acetonide for diabetic macular edema. Fluorescein angiography demonstrated a superior temporal occlusive vasculitis. A diagnostic anterior chamber paracentesis was performed to obtain deoxyribo-nucleic acid (DNA) for a polymerase chain reaction (PCR) test for viral retinitis. PCR was positive for CMV. The patient was placed on intravenous ganciclovir. CMV retinitis is exceedingly rare in immunocompetent patients; however, it remains the most common cause of posterior uveitis in immunocompromised patients. The incidence of this entity remains unknown. Local immunosuppression, the dose and the frequency of injections may explain the occurrence of this severe retinitis.

• Authors: I Zghal, I Malek, C Amel, O Soumaya, H Bouguila, L Nacef
• Journal: Journal francais d'ophtalmologie (J Fr Ophtalmol) Vol. 36 Issue 7 Pg. e129-32 (Sep 2013) ISSN: 1773-0597 [Electronic] France
• Vernacular Title: Rétinite virale secondaire à une injection intravitréenne de triamcinolone.
• PMID: 23648134 (Publication Type: Case Reports, English Abstract, Journal Article)
• Copyright: Copyright © 2013. Published by Elsevier Masson SAS.

Chemical References

• Triamcinolone Acetonide

Topics

• Aged
• Cytomegalovirus Retinitis (etiology)
• Diabetic Retinopathy (drug therapy)
• Humans
• Intravitreal Injections (adverse effects)
• Macular Edema (drug therapy)
• Male
• Triamcinolone Acetonide (administration & dosage, adverse effects)