CYTOMEGALOVIRUS OCULAR INVOLVEMENT IN A KIDNEY TRANSPLANT RECIPIENT

MOUNA HAMOUDA, RİM KAHLOUN, LAZHER JABALLAH, SABRA ALOUİ, HABİB SKHİRİ, BECHİR JELLİTİ, MONCEF KHAİRALLAH, MEZRİ ELMAY

Experimental and Clinical Transplantation - 2018;16(4):495-498

Department of Nephrology and the Department of Ophthalmology, Fattouma Bourguiba Hospital, Monastir, Tunisia

 

Cytomegalovirus remains the most common infection after kidney transplant. We report cytomegalovirus retinitis and anterior uveitis, which developed consecutively within 1 year in a kidney transplant recipient. A 25-year-old man presented 5 months after transplant with decreased visual acuity in his left eye. Fundus examination revealed bilateral areas of necrotizing retinitis with intraretinal hemorrhages. The confirmation of cytomegalovirus disease was based on clinical findings and positive polymerase chain reaction for cytomegalovirus in plasma and in aqueous humor. The patient was treated with intravenous ganciclovir for 21 days and then with valacyclovir for 3 months. The patient’s symptoms improved, and fundus examination revealed resolution of retinitis with appearance of retinal scarring. One year later, the patient presented with cytomegalovirus anterior uveitis associated with increased intraocular pressure, which was treated with antiviral agents, antiglaucomatous eye drops, and trabeculectomy. Cytomegalovirus ocular involvement for our immunocompromised patient presented in 2 consecutive forms: bilateral retinitis and anterior uveitis. Early diagnosis and treatment of active cytomegalovirus retinitis and uveitis remain crucial to prevent their progression to irreversible visual impairment.