Purpose: We report five cases of cytomegalovirus (CMV) retinitis in immunocompetent patients with diabetes mellitus (DM).Methods: This was a retrospective observational case series of five immunocompetent patients with CMV retinitis. All patients had DM and variable degrees of DM retinopathy. After discovery of the retinitis, we assessed the patients in terms of ophthalmologic history, systemic conditions, underlying disease, and the medications used for treatment, such as immunosuppressants. This was followed by blood and immunology tests. None of the five patients were immunocompromised. We confirmed the diagnosis of CMV retinitis by polymerase chain reaction (PCR) analysis; samples were collected by anterior chamber paracentesis. All patients were treated with intravitreal antiviral injection until negative results were obtained for the anterior chamber PCR.Results: All five immunocompetent patients who had developed CMV retinitis, had a history of diabetes of at least 15 years. The average duration of diabetes was 17.4 ± 2.4 (15-20) years, the average HbA1c was 7.3 ± 0.5% (6.8-8.0%), and the average duration and numbers of Intravitreal antiviral injections were 23.8 ± 8.5 months (14-36 months) and 14.8 ± 3.2 times (10-18 times), respectively.Conclusions: We report this case series because CMV retinitis can be complicated even in diabetic patients shown to be immunocompetent.
The short-term outcomes of patients with diabetic macular edema (DME) treated with 0.1% Bromfenac eyedrops were evaluated. Methods: We included 14 eyes of 14 patients diagnosed with persistent macular edema after intravitreal bevacizumab injection to treat DME. Bromfenac sodium hydrate 0.9 mg/mL eyedrops were administered to the affected eye twice daily for 3 months. The best corrected visual acuity (BVCA) and central macular thickness (CMT) were measured before treatment and at 1, 2, and 3 months after treatment. We noted no adverse drug reaction such as corneal toxicity. Results: After 2 months of intravitreal bevacizumab and before Bromfenac eyedrops treatment, the logarithm of the minimal angle of resolution (logMAR) BCVA and the CMT were 0.40 ± 0.29 and 337 ± 97.3 μm, respectively. The logMAR BCVA decreased from 0.40 ± 0.29 to 0.39 ± 0.29 after 1 month, to 0.38 ± 0.24 after 2 months, and to 0.34 ± 0.21 after 3 months of Bromfenac treatment, but statistical significance was not attained (p = 0.93, p = 0.62, and p = 0.36 respectively). The CMT improved significantly from 337 ± 97.3 μm to 331 ± 67.9 μm after 1 month, 311 ± 89.1 μm after 2 months, and 282.9 ± 76.7 μm after 3 months (p = 0.47, p = 0.08, and p = 0.04, respectively). Treatment was well-tolerated; we noted no topical or systemic side-effect. Conclusions: Topical bromfenac may play a useful role in terms of reducing DME.
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