PDF(Pubmed)
Abstract：
Aim: To report a case of cytomegalovirus (CMV) neuroretinitis observed in an immunocompetent patient. Materials and methods: The patient presented with a complaint of diminution of vision in both eyes (BE) and had a traumatic cataract in the right eye (RE). Fundus examination of the left eye (LE) revealed an active white, fluffy lesion with an overlying retinal hemorrhage patch with a macular star. The diagnosis of CMV neuroretinitis was established, and the patient commenced treatment with valganciclovir. Results: The patient exhibited no underlying risk factors. Subsequently, a positive response to oral valganciclovir treatment was observed. Discussion: Cytomegalovirus (CMV) neuroretinitis is typically associated with immunocompromised individuals, such as those with HIV/AIDS. The patient\'s presentation with a traumatic cataract in the right eye and a distinctive fundus appearance in the left eye posed a diagnostic challenge. The absence of common risk factors for CMV infection necessitated a thorough examination and consideration of rare infectious etiologies. The positive response to valganciclovir reinforces its efficacy in managing CMV-related ocular conditions. This case emphasized the necessity for ophthalmologists to maintain a high index of suspicion for CMV and other unusual pathogens when faced with neuroretinitis in patients who do not present with typical systemic immunosuppressive conditions. Early diagnosis and appropriate antiviral therapy prevent potential complications and preserve vision in such atypical presentations. Conclusion: This case underscores the importance of considering rare infectious agents in immunocompetent patients when encountering neuroretinitis, particularly in the absence of typical symptoms or signs of the disease. Abbreviations: CMV = Cytomegalovirus, BE = Both eyes, RE = Right eye, LE = Left eye, CBC = Complete Blood Count, ESR = Erythrocyte Sedimentation Rate, VDRL = Venereal Disease Research Laboratory, FTA-ABS = Fluorescent Treponemal Antibody Absorption, PPD = Purified Protein Derivative, ANA = Anti-Nuclear Antibodies, RF = Rheumatoid Factor, ACE = Anti Converting Enzyme, Ig G = Immunoglobulin G, HSV = Herpes simplex virus.
摘要：
目的：报告1例有免疫能力的患者中观察到的巨细胞病毒（CMV）神经视网膜炎。材料和方法：患者表现为双眼视力下降（BE），右眼患有外伤性白内障（RE）。左眼眼底检查（LE）显示活跃的白色，蓬松病变，上面有视网膜出血斑，黄斑星形。建立CMV视神经网膜炎的诊断，患者开始接受伐更昔洛韦治疗。结果：患者无潜在危险因素。随后，观察到口服伐更昔洛韦治疗呈阳性反应.讨论：巨细胞病毒（CMV）神经视网膜炎通常与免疫受损的个体有关，如艾滋病毒/艾滋病患者。患者的表现为右眼的外伤性白内障和左眼的独特眼底外观构成了诊断挑战。缺乏CMV感染的常见危险因素，因此需要进行彻底检查并考虑罕见的感染性病因。对伐更昔洛韦的阳性反应增强了其在管理CMV相关眼部疾病中的功效。该病例强调了眼科医生在面对不存在典型系统性免疫抑制疾病的患者的神经视网膜炎时，必须保持对CMV和其他异常病原体的高度怀疑。早期诊断和适当的抗病毒治疗可以防止潜在的并发症，并在这种非典型表现中保持视力。结论：该病例强调了在遇到视神经视网膜炎时考虑免疫功能正常的患者中罕见感染因子的重要性，特别是在没有典型症状或体征的情况下。缩写：CMV=巨细胞病毒，BE=双眼，RE=右眼,LE=左眼,CBC=全血细胞计数,ESR=红细胞沉降率，VDRL=性病研究实验室，FTA-ABS=荧光蛋白抗体吸收,PPD=纯化的蛋白质衍生物，ANA=抗核抗体,RF=类风湿因子,ACE=抗转化酶，IgG=免疫球蛋白G,HSV=单纯疱疹病毒。
