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Case Reports
. 2014 Sep;30(Suppl 1):154-8.
doi: 10.1007/s12288-013-0305-9. Epub 2013 Dec 6.

An Interesting Case of CMV Retinitis in a Case of ALL on Maintenance Therapy

Pawan Kumar Singh  1 , Aniruddha Purushottam Dayama  1 , Rakhi Maiwall  2 , Vineet Sehgal  3 , Pradeep Venkatesh  3 , Pravas Chandra Mishra  1 , Tulika Seth  1 , Manoranjan Mahapatra  1
Affiliations
Case Reports

An Interesting Case of CMV Retinitis in a Case of ALL on Maintenance Therapy

Pawan Kumar Singh et al. Indian J Hematol Blood Transfus. 2014 Sep.

Abstract

Forty-five years old male, a known case of T cell acute lymphoblastic leukemia (ALL) on maintenance therapy presented with bilateral painless progressive diminution of vision. Evaluation revealed cytomegalovirus (CMV) retinitis with low CD4 counts. CMV retinitis is usually seen in HIV disease or in post allogenic stem cell transplant recipients. CMV retinitis occurring in ALL maintenance phase is very rare. The disease is aggressive and shows incomplete response to medical therapy.

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Figures

Fig. 1
Fig. 1
Fundoscopy image of left eye taken on 14-07-2012 showing hemorrhages and exudates present diffusely on the temporal and nasal part of the retina. Patient started having complaints of progressive painless diminution of vision in the left eye for which this fundoscopy was done. These lesions were typical of CMV retinitis
Fig. 2
Fig. 2
Fundoscopy image of right eye taken on 13-09-2012 showing diffuse exudates and minimal hemorrhages present on temporal and nasal part of the retina. Patient started complaining of progressive painless diminution of vision in right eye also while on Inj Ganciclovir therapy which was recently started on 08-09-2012
Fig. 3
Fig. 3
Fundoscopy image of right eye taken on 11-02-2013 showing normal retina with healed lesions seen previously and the patient also having vision of 6/36 in right eye
Fig. 4
Fig. 4
Fundoscopy image of left eye taken on 11-02-2013 still showing diffuse hemorrhages, exudates and scarring involving temporal and nasal part of the retina. There was also evidence of retinal detachment. At this point of time his vision was just finger counting at 1 m
See this image and copyright information in PMC

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