Cytomegalovirus retinitis in five immunocompromised patients without acquired immunodeficiency syndrome

We observed five bilateral cases of typical cytomegalovirus (CMV) retinitis unrelated to acquired immunodeficiency syndrome (AIDS). Three cases had been receiving long-term systemic corticosteroid and immunosuppressive drugs for systemic diseases. Two cases had been under chemotherapy for malignancy. CMV was isolated from the urine and throat. CMV-specific DNA was detected in the aqueous or the vitreous processed by polymerase chain reaction in the other 4 cases. The retinitis subsided without relapse in 4 cases after antiviral therapy with ganciclovir or acyclovir followed by surgery. In the other one unilaterally affected case, retinitis developed in the fellow eye later despited systemic acyclovir. This patient died eventually. These cases illustrate that CMV retinitis in patients unrelated to AIDS may be effectively treated after appropriate diagnosis and treatment and after improved systemic status.