Delyfer Marie-Noëlle, Rougier Marie-Bénédicte, Hubschman Jean-Pierre, Aouizérate Franck, Korobelnik Jean-François
Vitreo-Retinal Unit, Department of Ophthalmology, Bordeaux Univeristy Hospital, Bordeaux, France.
Acta Ophthalmol Scand. 2007 Sep;85(6):681-3. doi: 10.1111/j.1600-0420.2007.00915.x. Epub 2007 Apr 2.
Cytomegalovirus (CMV) retinitis usually affects severely immunosuppressed individuals. However, some exceptional and isolated cases of CMV retinitis have been described in immunocompetent patients.
We report two cases of non-immunodeficient patients seen in our institution over a period of 6 months, who presented with CMV retinitis a few weeks after an intravitreal injection of triamcinolone acetonide.
Although the cellular and molecular mechanisms underlying the development of CMV in an immunocompetent patient's eye have not yet been precisely established, the well known immunosuppressive properties of corticosteroids suggest that triamcinolone probably plays a role in the endogenous reactivation of latent CMV.
Our two patients received high doses of triamcinolone. Both had also pseudophakia, vitrectomy and a past medical history of type 2 diabetes mellitus. Such features, individually or combined, may be risk factors for local reactivation of CMV and should be considered prior to the administration of triamcinolone acetonide in ophthalmology.
巨细胞病毒（CMV）视网膜炎通常影响严重免疫抑制的个体。然而，在免疫功能正常的患者中也有一些特殊的、孤立的CMV视网膜炎病例被描述。
我们报告了在6个月期间在我们机构见到的2例非免疫缺陷患者，他们在玻璃体内注射曲安奈德几周后出现了CMV视网膜炎。
尽管免疫功能正常的患者眼中CMV发生发展的细胞和分子机制尚未完全明确，但皮质类固醇众所周知的免疫抑制特性表明曲安奈德可能在潜伏性CMV的内源性再激活中起作用。
我们的2例患者接受了高剂量的曲安奈德。两人均有假晶状体、玻璃体切除术和2型糖尿病病史。这些特征单独或综合起来，可能是CMV局部再激活的危险因素，在眼科应用曲安奈德之前应予以考虑。
