Seki Kyosuke, Harimoto Kozo, Takeuchi Masaru
Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.
Ocul Immunol Inflamm. 2022 Oct-Nov;30(7-8):2017-2018. doi: 10.1080/09273948.2021.1944647. Epub 2021 Jul 2.
To report a case of cytomegalovirus retinitis (CMVR) with hypopyon and intense ocular inflammation.
An 81-year-old female was referred to our hospital with a suspicion of postoperative endophthalmitis in the left eye. She had been treated with etoposide and prednisolone for non-Hodgkin's lymphoma. Examination revealed mutton-fat keratic precipitates and numerous infiltrating cells in the anterior chamber with hypopyon. The fundus was invisible due to intense vitreous opacity. Systemic and topical administration of antibiotics was started, and vitrectomy was performed. However, the ocular symptoms did not respond to treatment. Vitrectomy was repeated twice, but severe endophthalmitis findings recurred soon after surgery. Finally, a comprehensive viral PCR test using the intraocular fluid detected CMV with 3.34 × 10 copies/ml, leading to a diagnosis of CMV retinitis.
If the causative agent is not identified in endophthalmitis that develops in immunosuppressive patients, CMV may also be considered as the possible cause.
报告一例伴有前房积脓和严重眼部炎症的巨细胞病毒性视网膜炎（CMVR）病例。
一名81岁女性因左眼疑似术后眼内炎被转诊至我院。她曾接受依托泊苷和泼尼松龙治疗非霍奇金淋巴瘤。检查发现前房有羊脂状角膜后沉着物和大量浸润细胞伴前房积脓。由于玻璃体严重混浊，眼底无法看清。开始全身及局部应用抗生素，并进行了玻璃体切除术。然而，眼部症状对治疗无反应。玻璃体切除术重复了两次，但术后很快又出现严重的眼内炎表现。最后，使用眼内液进行的全面病毒PCR检测发现巨细胞病毒，浓度为3.34×10拷贝/毫升，从而诊断为CMV视网膜炎。
在免疫抑制患者发生的眼内炎中，如果未确定病原体，也可考虑巨细胞病毒为可能病因。
