眼内注射地塞米松植入剂后发生闭塞性巨细胞病毒性全葡萄膜炎。
OCCLUSIVE CYTOMEGALOVIRUS PANUVEITIS AFTER INTRAVITREAL DEXAMETHASONE IMPLANT.
机构信息
University of Cincinnati College of Medicine, Cincinnati, OH; and.
Cincinnati Eye Institute, Cincinnati, OH.
出版信息
Retin Cases Brief Rep. 2024 Jul 1;18(4):442-445. doi: 10.1097/ICB.0000000000001407.
PURPOSE
To report a case of unilateral cytomegalovirus (CMV) panuveitis with occlusive vasculitis after injection of intravitreal dexamethasone implant in a patient with type 2 diabetes mellitus.
METHODS
Observational case report.
RESULTS
A 60-year-old immunocompetent man with well-controlled type 2 diabetes mellitus was treated with intravitreal dexamethasone implant for recurrent uveitis that was responsive to steroids. Three months after implantation, the patient develops panuveitis with occlusive vasculitis. Anterior chamber tap confirms diagnosis of cytomegalovirus retinitis. Intravitreal foscarnet and oral valganciclovir led to quiescent disease.
CONCLUSIONS
Patients treated with local immunosuppressants should be monitored carefully to assess treatment response and complications, even in the absence of frank immunodeficiency. Quantitative viral PCR can be an effective way to monitor treatment response to antiviral therapy.
目的
报告一例 2 型糖尿病患者在玻璃体内注射地塞米松植入物后发生单侧巨细胞病毒（CMV）全葡萄膜炎伴闭塞性血管炎。
方法
观察性病例报告。
结果
一名 60 岁免疫功能正常的 2 型糖尿病患者，因复发性对类固醇有反应的葡萄膜炎接受玻璃体内地塞米松植入物治疗。植入后 3 个月，患者出现全葡萄膜炎伴闭塞性血管炎。前房穿刺术证实巨细胞病毒性视网膜炎的诊断。玻璃体内膦甲酸和口服缬更昔洛韦使疾病处于静止状态。
结论
即使没有明显的免疫缺陷，接受局部免疫抑制剂治疗的患者也应密切监测以评估治疗反应和并发症。定量病毒 PCR 可作为监测抗病毒治疗反应的有效方法。
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