Visual symptoms in patients on cyclophosphamide may herald sight threatening disease
- 1Department of Ophthalmology, St James University Hospital, Beckett Street, Leeds, UK
- 2Department of Ophthalmology, University of Bristol, Bristol, UK
- 3Department of Ophthalmology, Aberdeen Royal Infirmary, Aberdeen, UK
- Correspondence to: John A Olson, Department of Ophthalmology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK; J.Olson{at}arh.grampian.scot.nhs.uk
- Accepted 3 July 2002
Cytomegalovirus retinitis is a sight threatening, opportunistic infection of the neurosensory retina. Most cases occur in patients with AIDS,1,2 organ transplantation, or haematological malignancies.3 There are only a few isolated reports of cytomegalovirus retinitis complicating systemic immunosuppressive therapy in patients with collagen vascular diseases.4–6
Case reports
We reviewed four patients on long term immunosuppression for collagen vascular disease who developed cytomegalovirus retinitis. The retinitis was diagnosed on the basis of clinical presentation and laboratory testing including cytomegalovirus antibodies and/or viral culture and polymerase chain reaction for cytomegalovirus DNA of ocular fluid. CD4 and CD8 counts were obtained using FACS analysis of peripheral blood.
Two patients had systemic lupus erythematosus, one patient had Wegener’s granulomatosis and the fourth patient had classic polyarteritis nodosa. Full patient details are given in Table 1. In summary, all patients were receiving combination immunosuppressive therapy. All patients were …
