CYSTOID MACULAR EDEMA FOLLOWING TREATMENT OF CYTOMEGALOVIRUS (CMV) RETINITIS WITH CIDOFOVIR
C. Althaus, A. Kersten
Background: Cidofovir is a very potent agent in treatment of CMV retinitis. It is used intravenously and intravitreally. Known ocular complications are hypotony and iridocyclitis.
Method: Case report of 3 patients with development of severe cystoid macular edema (CME) following systemic (n=1) and intraocular application of cidofovir (n=2) in 3 eyes with CMV retinitis. Result: One patient under maintenance treatment with 5 mg/kg cidofovir i.v. every two weeks, developed a severe CME 5 weeks following a mild iritis with hypotony in the same eye. Two patients developed a severe CME 3 respectively 63 days following intravitreal injection of 15 µg cidofovir. All 3 patients received probenecid prophylactically. With repeated parabular steroid injections in all 3 eyes visual acuities improved, but the CME did not resolve completely. Conclusion: Severe, potentially persisting CME must be considered as a complication of intravenous and intravitrel cidofovir therapy in eyes with CMV retinitis. This risk must be weighted against the advantages of such a therapy.
Eye Hospital, Heinrich-Heine-University, Moorenstrasse 5, 40225 Duesseldorf