Cytomegalovirus retinitis after intravitreous triamcinolone treatment of a vitrectomized eye in an immunocompetent patient.

Purpose: To report a case of cytomegalovirus (CMV) retinitis after intravitreous injection of triamcinolone for a vitrectomized eye in an immunocompetent patient.

Design: Observational case report.

Methods: Review of medical records.

Results: A 54-year-old woman with well-controlled type 2 diabetes developed anterior uveitis, papillitis, retinal vasculitis, and retinal exudates 3 months after intravitreous triamcinolone for the treatment of recurred macular edema. The intravitreal white mass of triamcinolone was ophthalmoscopically observed on the inferior peripheral retina. Polymerase chain reaction of the vitreous was positive for CMV DNA. There was no sign of systemic CMV infection. Laboratory examination revealed that the patient was a human T cell lymphotropic virus type 1 carrier and HIV negative. The retinitis responded well to systemic ganciclovir and intravitreous foscarnet, but the treatment of anterior uveitis and vitreous opacity needed repeated vitreous surgery.

Conclusion: CMV retinitis can occur after intravitreous triamcinolone for a vitrectomized eye in an immunocompetent patient.