EPOS

European Paediatric Ophthalmological Society

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26 Should active CMV retinitis in non-immunocompromised newborn babies be treated?

Barampouti F.e, Rajan, M., Aclimandos W.
King's College Hospital, London

Purpose: : To describe a case of CMV retinitis in a presumed immunocompetent newborn baby with congenital CMV that progressed postnatally, our treatment regimen and a literature review on this subject.

Methods: : We examined a nine days old baby with congenital CMV infection and active CMV retinitis. The retinitis was present in both eyes and progressed within a day. Treatment with Gancyclovir 5 mg/kg was started and continued for three weeks.

Results: : One week after initiation of treatment complete resolution of the ocular inflammation occurred. The macula of the right eye remained unaffected, but scarring occurred in the periphery of both eyes and the left macula. On last examination at five months of age the baby would not fixate with the left eye and had developed a divergent squint, while he was fixing on bright objects with his right eye.

Conclusion: It is important to be aware that active and progressive CMV retinitis can occur in children with symptomatic congenital CMV infection who are not otherwise immunocompromised. Urgent assessment and prompt initiation of treatment is likely to improve the visual prognosis by arresting the necrotising retinitis from spreading to the posterior pole, or the contralateral eye.