Hypertensive iridocyclitis associated with delayed onset biopsy proven Cytomegalovirus retinitis.

Abstract:

:We describe a case of primary hypertensive iridocyclitis with biopsy-proven Cytomegaloviral retinitis. It is an observational case report of a 69-year-old diabetic gentleman on azathioprine for Crohn's disease who presented with recurrent episodes of hypertensive iridocyclitis. On the 4 th attendance in 5 months, a granular white lesion was noted in the temporal periphery of the mid-peripheral fundus and a chorioretinal and vitreous biopsy performed. Vitreous PCR was positive for Cytomegalovirus (CMV). Hematoxylin and eosin staining revealed cytomegalic-like inclusions within necrotic neural retina. Transmission electron microscopy revealed herpes family virus particles and immunohistochemistry demonstrated CMV protein. This case provides further evidence implicating CMV infection in the etiology of hypertensive iridocyclitis. With hindsight, the cumulative effect of diabetes and azathioprine on the immune surveillance system proved sufficient to render the patient susceptible to CMV retinitis.

journal_name

Indian J Ophthalmol

authors

Squirrell DM,Bhatta S,Mudhar HS,Rennie IG

doi

10.4103/0301-4738.97086

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

656-8

issue

5

eissn

0301-4738

issn

1998-3689

pii

97086

journal_volume

62

pub_type

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