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Three cases of cytomegalovirus retinitis confined to the macula Noriko Yoshida 1 , Sayuri Shu 1 , Hideki Miyasaka 1 , Toshinori Murata 1 1Department of Ophthalmology, Shinshu University School of Medicine pp.742-749
Published Date 2025/6/15
DOI https://doi.org/10.11477/mf.037055790790060742
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Abstract Purpose:This report presents three cases of cytomegalovirus(CMV)retinitis confined to the macula.

Case:Case 1 was a 23-year-old man diagnosed with intestinal Behçet's disease at 4 years of age had no history of uveitis. Routine ophthalmologic examination revealed that visual acuity was 0.7 in the left eye. A yellowish-white lesion was observed in the superior nasal aspect of the fovea of the left eye;this lesion extended to the fovea 6 months later. Arteritis was observed at the same site. Optical coherence tomography(OCT)revealed a hyperintense lesion with loss of all retinal structures. Anterior chamber aqueous humor PCR was positive for CMV. Ganciclovir infusion was commenced;however, the lesion recurred repeatedly and extended to the auricular side of the fovea. OCT revealed loss of all layers nine months after the onset, with only the inner limiting membrane being retained.

 Case 2 was a 54-year-old man receiving prednisolone for systemic lupus erythematosus for 5 years who was referred to our department with visual acuity loss in the left eye. Yellow-white macular lesions and linear hemorrhage were observed. Visual acuity was 0.06. The yellow-white lesions had decreased in size since the previous visit;however, sheathing arteries and hemorrhagic spots were observed. OCT performed previously revealed loss of all retinal layers, which was suggestive of CMV retinitis. Anterior chamber aqueous humor PCR was positive for CMV.

 Case 3 was a 62-year-old man referred to our department with vision loss, yellow-white lesions, and hemorrhagic spots observed one week earlier. Visual acuity was 0.3 in the right eye. Fluorescein angiography revealed arteritis in the lesion. OCT revealed retinal defects in a hyperintense lesion with loss of the laminar structure, which was suggestive of CMV. Anterior chamber aqueous humor PCR was positive for CMV.

Conclusion:CMV retinitis confined to the macula were observed in all three cases. OCT revealed hyperintense lesions with loss of all layers of retinal structure in the early stages, followed by gradual loss of retinal structure.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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