Abstract
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Highlights
A 64-year-old man with myasthenia gravis (MG) presented with blurry vision in his left eye (OS)
There was a decrease in the dosage and eventual cessation of mycophenolate mofetil (MMF) with initiation of intravenous immunoglobulins. His lymphocytes improved to 9.8%
On valganciclovir discontinuation in week 10, the patient had a visual acuity of 20/25 OS with no inflammation and improvements in retinal hemorrhages and lesions
Summary
A 64-year-old man with myasthenia gravis (MG) presented with blurry vision in his left eye (OS) His visual acuity was 20/20 in the right eye and 20/50 OS. He had 1+ vitritis and vaso-occlusive appearance of the retina with sclerotic vessels and hemorrhages in the inferonasal quadrant OS (Figure 1), consistent with features of cytomegalovirus (CMV) retinitis. He was immunocompromised secondary to mycophenolate mofetil (MMF) administered for MG, with 0.6% lymphocytes (normal: 26.0–46.0%), a lymphocyte count of 0.1×103 cells/μL, and a leukocyte count of 11.3×103 cells/μL. The human immunodeficiency virus (HIV) test result was negative, and no further workup for immunosuppression, including cancer, was conducted
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