A rare case of cytomegalovirus papillitis in patient with immunodeficiency
Abstract: A 26-year-old male
diagnosed with AIDS came with sudden blurred vision and central sco-toma in
left eye since 2 weeks before admission. His visual acuity was counting finger
at 5 meters with normal IOP and anterior segment. The posterior segment
revealed edematous optic nerve covered by exudates and hemorrhages. Due to low
CD4+ count and serological test result, we considered a HIV-related
opportunistic ocular infection, specifically HSV infection. As visual acuity
worsened during treatment with acyclovir, we performed PCR ex-amination from
aqueous tap which revealed positive CMV DNA. Unfortunately, the visual acuity
had worsened to no light perception before he received any specific anti-CMV
agent. CMV papillitis is an unusual presentation of CMV retinitis. PCR
examination from aqueous or vitreous tap should be performed while waiting for
serological test result, especially in doubtful cases. Therefore, appropriate
diagnosis and management can be established early to prevent irreversible
visual loss.
Author: Dinda A. Devona, Made
Susiyanti
Journal Code: jpkedokterangg160150
