Cytomegalovirus Endotheliitis after Fluocinolone Acetonide (Retisert) Implant in a Patient with Behçet Uveitis

• Published in: Ocular immunology and inflammation Vol. 19; no. 4; pp. 282 - 283
• Main Authors: Park, Un Chul, Kim, Sang Jin, Yu, Hyeong Gon
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.08.2011; Taylor & Francis
• Subjects: Administration, Oral; Adult; Anti-Inflammatory Agents - administration & dosage; Antiviral Agents - administration & dosage; Behcet Syndrome - complications; Behcet's uveitis; Corneal Edema - complications; Corneal Edema - drug therapy; Corneal Edema - virology; Cytomegalovirus; cytomegalovirus endotheliitis; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - drug therapy; Drug Implants - adverse effects; Endothelium, Corneal - virology; fluocinolone acetonide; Fluocinolone Acetonide - administration & dosage; Ganciclovir - administration & dosage; Ganciclovir - analogs & derivatives; Humans; Inflammation - complications; Inflammation - drug therapy; Inflammation - virology; Male; Uveitis - drug therapy; Uveitis - etiology; Vision Disorders - etiology
• ISSN: 0927-3948; 1744-5078
• DOI: 10.3109/09273948.2011.580075

Purpose: To report a case of cytomegalovirus (CMV) endotheliitis after insertion of an intravitreal fluocinolone acetonide (Retisert) implant. Design: Interventional case report. Methods: Retrospective chart review. Results: A 40-year-old man received a Retisert implant in the left eye for recurrent Behçet uveitis. Although inflammation became quiescent within a month, corneal edema developed 4 months after insertion. Polymerase chain reaction analysis for aqueous humor detected 3.9 × 104 copies/mL of CMV DNA. After treatment with oral valganciclovir, CMV DNA nearly disappeared but visual outcome was poor due to corneal decompensation resulting from severe endothelial cell loss. Conclusions: After Retisert implant, clinicians should be attentive to the potential risk of CMV endotheliitis.