Cytomegalovirus Retinitis with Hypopyon Similar to Bacterial Endophthalmitis in a Patient with non-Hodgkin’s Lymphoma

ABSTRACT

Purpose

To report a case of cytomegalovirus retinitis (CMVR) with hypopyon and intense ocular inflammation.

Case report

An 81-year-old female was referred to our hospital with a suspicion of postoperative endophthalmitis in the left eye. She had been treated with etoposide and prednisolone for non-Hodgkin’s lymphoma. Examination revealed mutton-fat keratic precipitates and numerous infiltrating cells in the anterior chamber with hypopyon. The fundus was invisible due to intense vitreous opacity. Systemic and topical administration of antibiotics was started, and vitrectomy was performed. However, the ocular symptoms did not respond to treatment. Vitrectomy was repeated twice, but severe endophthalmitis findings recurred soon after surgery. Finally, a comprehensive viral PCR test using the intraocular fluid detected CMV with 3.34 × 10⁹ copies/ml, leading to a diagnosis of CMV retinitis.

Conclusions

If the causative agent is not identified in endophthalmitis that develops in immunosuppressive patients, CMV may also be considered as the possible cause.

KEYWORDS:

• Cytomegalovirus
• cytomegalovirus retinitis
• endophthalmitis
• infectious uveitis
• non-Hodgkin’s lymphoma

Acknowledgments

The requirement for informed consent was waived by the ethics committee of National Defense Medical College.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.