Cytomegalovirus Retinitis in a Patient with Idiopathic Thrombocytopenic Purpura on Oral Prednisolone Treatment: A Case Report

Abstract

Purpose: To present one case of cytomegalovirus (CMV) retinitis in an idiopathic thrombocytopenic purpura patient on oral prednisolone therapy. Methods: A case report. Results: A 55-year-old female patient was treated with oral Prednisolone for idiopathic thrombocytopenic purpura (ITP) for 6 months. She suffered from pneumocystic carinii pneumonia, which eventually resulted in respiratory failure and the patient received endotracheal tube intubation in April 2008. Serum HIV was negative. One month later, she presented with redness in her left eye. Fundus examinations suggested acute retinal necrosis, and she was placed on intravenous Acyclovir therapy. Aspiration of the aqueous from the anterior chamber demonstrated a positive reaction to CMV DNA by using polymerase chain reaction (PCR). The medication was switched to intravenous Ganciclovir therapy. Vitritis, cotton wool spots, and granular retinitis were improved after Ganciclovir therapy. The patient's visual function recovered completely one month later. Conclusions: Cytomegalovirus retinitis rarely occurs in patients with ITP and under steroid treatment. Aqueous aspiration for virus DNA detection by PCR is recommended to confirm the diagnosis.