Epiretinal membrane in a 12-year-old immunocompetent girl with cytomegalovirus infection

Eur J Ophthalmol. 2009 Nov-Dec;19(6):1098-101. doi: 10.1177/112067210901900637.

Abstract

Purpose: To report the case of a 12-year-old immunocompetent girl presenting bilateral epiretinal membrane formation in conjunction with systemic human cytomegalovirus (HCMV) infection.

Methods: The patient had a sudden onset of blurred vision and floaters in both eyes. Her medical history was unremarkable, except for allergic asthma that she had had for several years and that she was treating with inhaler corticosteroids prescribed by her pediatrician. The patient underwent a complete ophthalmic examination and serologic blood test.

Results: The ocular examination revealed an epiretinal membrane confirmed by optical coherence tomography, which showed a band of high optical reflectivity compatible with a proliferation of abnormal tissue on the surface of the retina. The patient had serologic evidence of exposure to HCMV, which was verified by a strongly positive HCMV IgM antibody test result (320 IU), with detectable IgG antibodies against HCMV, which significantly rose further in consecutive blood samples, due to IgG antibody seroconversion.

Conclusions: Our patient had allergic asthma that she was treating with inhaled corticosteroids. The immunosuppressive properties of corticosteroids could induce endogenous reactivation of latent HCMV.

Publication types

  • Case Reports

MeSH terms

  • Androstadienes / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Viral / blood
  • Asthma / complications
  • Asthma / drug therapy
  • Child
  • Cytomegalovirus / physiology
  • Cytomegalovirus Retinitis / diagnostic imaging
  • Cytomegalovirus Retinitis / immunology
  • Cytomegalovirus Retinitis / virology*
  • Epiretinal Membrane / diagnostic imaging
  • Epiretinal Membrane / immunology
  • Epiretinal Membrane / virology*
  • Female
  • Fluorescein Angiography
  • Fluticasone
  • Humans
  • Immunocompetence / physiology*
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Tomography, Optical Coherence
  • Ultrasonography
  • Virus Activation / drug effects

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • Fluticasone