雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A case of chronic necrotizing retinitis with a difficulty for topical ocular treatment due to secondary retinal detachment Keiichiro Konno 1 , Masahiko Sugimoto 1,2 , Hiroyuki Otoda 3 , Kohei Tanaka 4 , Taku Sasaki 1 , Shinichiro Chujo 1 , Yoshitsugu Matsui 1 , Kumiko Kato 1 , Hisashi Matsubara 1 , Mikio Saso 5 , Mineo Kondo 1 1Department of Ophthalmology, Mie University Graduate School of Medicine 2Department of Ophthalmology and Visual Science, Faculty of Medicine, Yamagata University 3Department of Ophthalmology, Ise Red Cross Hospital 4Department of Ophthalmology, Nabari City Hospital 5Department of Ophthalmology, Mie Prefectural General Medical Center pp.562-568
Published Date 2024/5/15
DOI https://doi.org/10.11477/mf.1410215166
  • Abstract
  • Look Inside
  • Reference

Abstract Purpose:Chronic retinal necrosis(CRN)occurs in mildly immunocompromised patients and is a slowly progressive condition involving necrotizing retinitis and occlusive retinal vasculitis in the retinal periphery. The pathogenesis is believed to involve viral infections, and local ocular drug administration is used. In this report, we describe a case of CRN in which systemic administration of a drug was necessary because of concomitant retinal detachment.

Case:In a 78-year-old man, cytomegalovirus(CMV)retinitis was suspected and he was referred to our hospital for a thorough assessment. He had a history of diabetes mellitus and chemotherapy for prostate cancer. Although the left eye was HIV-negative, the blood revealed pancytopenia and CMV-IgG positivity. A vitreous biopsy comfirmed CMV, and CRM associated with mild hypoimmunity was diagnosed. Four days postoperatively, the patient developed retinal detachment due to a peripheral rhegmatogenous tear, and reoperation was performed and terminated with silicone oil filling. Because of this, vitreous ganciclovir, a first-line drug, was difficult to administer, and systemic administration was initiated at 200 mg/day. Although the retinal findings subsided with drug administration, the patient experienced systemic complications.

Conclusion:Because systemic complications from systemic administration of drugs can be difficult to treat, if CRN is suspected, treatment should be planned in situations where ocular topical administration is feasible, avoiding excessively invasive procedures.


Copyright © 2024, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

関連文献

もっと見る

文献を共有