Abstract | RATIONALE: Intraocular infection of Epstein-Barr virus (EBV) may cause severe visual loss. However, it is relatively rare, and there is no consensus on its treatment. PATIENT CONCERNS: A 44-year-old woman complained of a right-eye floater and exhibited a unilateral exudative change along the retinal veins at the Department of Ophthalmology, St. Luke's International Hospital. DIAGNOSIS: EBV retinitis was diagnosed based on EBV-positive (9.09 × 103 copies/μl) and cytomegalovirus-negative results in the aqueous humor. INTERVENTIONS: OUTCOMES: The intraocular MTX administration reduced the inflammatory vitreous and retinal infiltration, but not the EBV load, while foscarnet reduced the EBV load and papillitis, but not vitreous infiltration. LESSONS: The retinal infiltration may have involved EBV infection to the retinal neurons but also EBV-free reactive inflammatory cells. EBV infection to the neurons may have been, at least partially, treated by intravitreal foscarnet treatment, and the reactive inflammatory cells by intravitreal MTX. Further observations are warranted to reach a consensus on treating intraocular EBV infection.
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Authors | Yasuaki Mushiga, Tatsunori Komoto, Norihiro Nagai, Yoko Ozawa |
Journal | Medicine
(Medicine (Baltimore))
Vol. 100
Issue 48
Pg. e28101
(Dec 03 2021)
ISSN: 1536-5964 [Electronic] United States |
PMID | 35049237
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. |
Chemical References |
- Steroids
- Foscarnet
- Methotrexate
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Topics |
- Adult
- Epstein-Barr Virus Infections
(complications, drug therapy)
- Female
- Foscarnet
(therapeutic use)
- Herpesvirus 4, Human
(isolation & purification)
- Humans
- Methotrexate
(therapeutic use)
- Papilledema
(etiology)
- Pulse Therapy, Drug
- Retinitis
(diagnosis, drug therapy, microbiology)
- Steroids
- Treatment Outcome
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