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Abstract：
Purpose: To describe an immunocompetent patient with cytomegalovirus (CMV) retinitis after dexamethasone implant injection and review previously documented cases. Methods: A review of case reports and literature was performed. Results: A 75-year-old man presented with acute decreased vision in the left eye. He had a vitrectomy and membrane peeling for an epiretinal membrane with recurrent cystoid macular edema and was receiving intravitreal dexamethasone implant injections at an outside hospital. The visual acuity in the left eye was hand motions, and an examination found patchy retinal whitening with hemorrhages. Aqueous polymerase chain reaction was positive for CMV. The laboratory evaluation was negative for immunodeficiencies. He was treated successfully with intravitreal and oral antivirals; however, his vision remained poor at most recent follow-up. A literature review found 8 previous cases of CMV retinitis after dexamethasone implant injection, although most had underlying immune dysregulation. Conclusions: CMV retinitis after intravitreal dexamethasone implant injection is rare. Awareness of this complication is essential because of the risk for devastating blindness.
摘要：
目的：描述地塞米松植入物注射后患有巨细胞病毒（CMV）视网膜炎的免疫功能正常患者，并回顾先前记录的病例。方法：复习病例报告和文献。结果：一名75岁的男性左眼视力严重下降。他进行了玻璃体切除术和视网膜前膜剥离，复发性囊样黄斑水肿，并在医院外接受玻璃体内地塞米松植入物注射。左眼的视力是手部动作，检查发现斑驳的视网膜变白并伴有出血。水性聚合酶链反应对CMV呈阳性。实验室评估对免疫缺陷呈阴性。他用玻璃体内和口服抗病毒药物成功治疗；然而，在最近的随访中，他的视力仍然很差。文献回顾发现8例CMV性视网膜炎在地塞米松植入物注射后，尽管大多数都有潜在的免疫失调。结论：玻璃体腔注射地塞米松后CMV视网膜炎罕见。对这种并发症的认识是至关重要的，因为存在毁灭性失明的风险。
