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BRIEF COMMUNICATION
Year : 2014  |  Volume : 62  |  Issue : 5  |  Page : 656-658

Hypertensive iridocyclitis associated with delayed onset biopsy proven Cytomegalovirus retinitis


1 Department of Ophthalmology, Greenlane Clinical Centre, Auckland, NewZealand
2 Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
3 Department of Pathology, Royal Hallamshire Hospital, Sheffield, United Kingdom

Correspondence Address:
Sudipto Bhatta
Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, S10 2JF
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.97086

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We describe a case of primary hypertensive iridocyclitis with biopsy-proven Cytomegaloviral retinitis. It is an observational case report of a 69-year-old diabetic gentleman on azathioprine for Crohn's disease who presented with recurrent episodes of hypertensive iridocyclitis. On the 4 th attendance in 5 months, a granular white lesion was noted in the temporal periphery of the mid-peripheral fundus and a chorioretinal and vitreous biopsy performed. Vitreous PCR was positive for Cytomegalovirus (CMV). Hematoxylin and eosin staining revealed cytomegalic-like inclusions within necrotic neural retina. Transmission electron microscopy revealed herpes family virus particles and immunohistochemistry demonstrated CMV protein. This case provides further evidence implicating CMV infection in the etiology of hypertensive iridocyclitis. With hindsight, the cumulative effect of diabetes and azathioprine on the immune surveillance system proved sufficient to render the patient susceptible to CMV retinitis.


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