Follow-up Lymphoma Related CMV Retinitis

The above OCT’s, are from the previous case of acute retinal necrosis, which are two week follow up from vitrectomy with negative vitreous PCRs. Notice the right eye OCT, complete macular atrophy, destroyed from the herpes zoster. The patient at one day post op, was given a prescription for oral valtrex, to prevent spread of the virus, was non compliant with filling the prescription. At two week post op check, the right eye vision checked at hand motion with projection, and the left eye at 20/80. Patient had a new complaint at this visit, reduced reading vision in the left eye. Dilated fundus exam and OCT revealed viral spread to the left eye. Notice the hyperreflective areas nasal and temporal to the fovea (red arrows). These are areas where the retina is necrotic, and will soon become atrophic like the right retina. Patient was given in intravitreal injection of foscarnet 2.4 mg in the left eye and was admitted to the hospital for intravenous ganciclovir.