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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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CYTOMEGALOVIRUS RETINITIS IN AN INFANT WITH SEVERE COMBINED IMMUNODEFICIENCY – A CASE REPORT.

Nuno Moura-Coelho1, Ricardo Figueiredo2, José Neri Pires1, Sara Crisóstomo1, Lívio Costa1, Cristina Brito1

1 Serviço de Oftalmologia, Centro Hospitalar de Lisboa Central, Lisboa
2 Serviço de Oftalmologia, Hospital do Espírito Santo, Évora

- European Society of Ophthalmology Congress 2017, Barcelona, 10-13 junho de 2017.
- Electronic Poster Presentation

Purpose: Congenital and perinatal cytomegalovirus (CMV) infection is an important cause of morbidity in immunocompromised infants, affecting multiple organs; CMV retinitis (CMVR) is typically characterized by a necrotizing retinitis, which is usually bilateral in children. The authors revise a case of perinatal CMVR from our institution.
Methods: A 3 month-old female infant diagnosed with severe combined immunodeficiency syndrome and disseminated CMV infection underwent ophthalmological examination for the presence of CMVR. Fundus examination was recorded and monitored by digital ocular imaging.
Results: At diagnosis, fundus examination revealed bilateral, multiple foci of active retinitis in the posterior pole and mid-periphery, with a focus of periphlebitis in the superior temporal retinal vein in her right eye (OD, and a juxta-foveolar lesion in the left eye (OS). No vitritis was observed. The infant was started on systemic ganciclovir and foscarnet therapy, and at week 7 of follow-up, retinal lesions showed progression to scarring.
Conclusions: Perinatal CMVR infection may affect multiple organs and systems and cause further morbidity in immunocompromised infants. Digital ocular imaging is a valuable tool in the evaluation of disease activity and progression of CMVR in infants.

Keywords: Cytomegalovirus (CMV); Severe Combined Immune Deficiency Syndrome (SCID); Perinatal CMV retinitis; Digital ocular imaging.