Korean J Ophthalmol.  2013 Feb;27(1):61-63. 10.3341/kjo.2013.27.1.61.

Cytomegalovirus Retinitis after Intravitreal Bevacizumab Injection in an Immunocompetent Patient

• Bae SH
• Kim TW
• Chung H
• Heo JW

• KMID: 1501800
• DOI: http://doi.org/10.3341/kjo.2013.27.1.61

Abstract

We report a case of cytomegalovirus (CMV) retinitis after intravitreal bevacizumab injection. A 61-year-old woman with diabetic macular edema developed dense vitritis and necrotizing retinitis 3 weeks after intravitreal bevacizumab injection. A diagnostic vitrectomy was performed. The undiluted vitreous sample acquired by vitrectomy was analyzed by polymerase chain reaction and culture. Polymerase chain reaction of the vitreous was positive for CMV DNA. Other laboratory results did not show evidence of other infectious retinitis and systemic immune dysfunction. Human immunodeficiency virus antibodies were also negative. After systemic administration of ganciclovir, retinitis has resolved and there has been no recurrence of retinitis during the follow-up period of 12 months. Ophthalmologists should be aware of potential risk for CMV retinitis after intravitreal bevacizumab injection.

Keyword

Bevacizumab; Cytomegalovirus; Retinitis

MeSH Terms

Angiogenesis Inhibitors/administration & dosage/adverse effects
Antibodies, Monoclonal, Humanized/administration & dosage/*adverse effects
Cytomegalovirus/genetics
Cytomegalovirus Retinitis/diagnosis/*etiology/immunology
DNA, Viral/analysis
Diagnosis, Differential
Female
Humans
Immunocompetence/*drug effects
Intravitreal Injections
Macular Edema/diagnosis/*drug therapy
Middle Aged
Polymerase Chain Reaction
Vascular Endothelial Growth Factor A/antagonists & inhibitors
Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
DNA, Viral
Vascular Endothelial Growth Factor A

Figure

• 

  Fig. 1 Fundus photograph of left eye taken during pars plana vitrectomy. Note the retinal vascular obliteration (A) and inferotemporal confluent necrotizing retinitis associated with retinal whitening (B). Inferior panretinal photocoagulation burns are also can be seen.

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