1. Necrotizing retinitis after intravitreal injection of triamcinolone
Juan Davó Cabrera
Enrique Alfonso Muñoz
FOM

2. CASE REPORT
A 47-year-old man with a decreased VA for 3 months in right eye.
Fundus examination: Epiretinal membrane next to a retinal scar.
It was performed a pars plana vitrectomy removing epiretinal membrane without complications and injecting intravitreal (iv) triamcinolone at the end of surgery.

3. CASE REPORT
1 month after surgery the patient presented in emergency room because of pain in right eye and a decrease in VA.
In the slit lamp, granulomatous uveitis was observed with vitritis and a central necrotizing retinitis.
Aqueous humor samples were obtained and iv Foscarnet injected.

4. CASE REPORT
Aqueous humor samples were obtained and iv Foscarnet was injected (suspect of acute retinal necrosis).
PCR was negative for herpes simplex virus, varicella zoster virus, CMV, EB and positive for T. gondii
Iv clindamycin was performed and repeated after 1 week

5. CONCLUSION
Acute retinal necrosis is the most frequent cause of necrotizing retinitis in inmmunocompetent patients.
However, intravitreal triamcinolone induces a local immnunocompromised environment that favors atypical forms such as Toxoplasmosis necrotizing retinitis.