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Cytomegalovirus in the Eye: Anterior and Posterior Manifestations Queenievic Nathalie Q. Fang, M.D. Objective: To compare cases of anterior and posterior uveitis secondary to Cytomegalovirus in immunocompetent and immunocompromised patients. Method: This is a case series. Resuts: A 41 year old, apparently healthy male consulted due to heaviness on the left eye accompanied by glare, which started 3 years prior to consult. Patient is a known case of primary open-angle glaucoma, and is on Latanoprost eye drops to both eyes. He is a known hypertensive. Best corrected visual acuity was 20/20 on both eyes. Slit lamp examination showed anterior chamber (AC) cells +1-+2, fine keratic precipitates on the lower left part of the cornea, and nodular endothelial lesion with endotheliitis, all on the left eye. Intraocular pressure (IOP) was 16 mmHg on the right, 33 mmHg on the left. The following laboratories were requested: complete blood count (CBC), antinuclear antibody (ANA), rheumatoid factor (RF), purified protein derivative (PPD), CMV IgM, CMV IgG, and polymerase chain reaction (PCR). Diagnosis was CMV anterior uveitis of the left eye. A 41 year old homosexual male consulted because of gradual blurring of vision of both eyes, accompanied by difficulty of breathing, diarrhea, weight loss, and skin rashes. CMV IgG antibody and CD4 cell count were requested. He was diagnosed with HIV and CMV retinitis. He was given IV ganciclovir for twenty-one days. Serial fundus photos were done. Conclusion: CMV uveitis can occur in an immunocompetent patient and usually presents in the anterior uvea. CMV retinitis is common in immunocompromised patients. |
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