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This abstract is assigned to session AOB and FRO E-Posters

Title	A case of CMV retinitis with different antiviral drug resistance-associated mutations in the genome of CMV strains in blood and aqueous humor
Abstract Nr.	3024

Purpose	To report a well-documented case of cytomegalovirus (CMV) retinitis with different genotypic resistance to antiviral drugs of the CMV strains in blood and aqueous humor.
Methods	Case report.
Results	A 60-year-old woman with a history of sequential single lung transplantation and multidrug resistant systemic CMV infection presented with bilateral blurred vision. Fundoscopic examination revealed bilateral retinitis, clinically suspicious of CMV retinitis. The diagnosis was confirmed by PCR testing of an aqueous humor sample. Genotyping revealed different mutations conferring resistance to anti-CMV drugs between the CMV strains in blood and aqueous humor samples. Systemic treatment options were limited, so antiviral therapy was initiated with intravitreal injections of ganciclovir and later foscarnet with good results.
Conclusion	This case report of multidrug resistant CMV retinitis illustrates that CMV disease may have different strains of virus in different tissues. Antiviral resistance of ocular CMV strains may develop independently from systemic antiviral resistance. Ophthalmologists should make every effort to obtain specimens for determination of CMV by PCR assay of vitreous or aqueous humor samples rather than only blood samples.
Conflict of interest	No

Authors 1

Last name	JACOBS
Initials	T
Department	Dept. of Ophthalmology, University Hospitals Leuven
City	Leuven

Authors 2

Last name	VAN CALSTER
Initials	J
Department	Dept. of Ophthalmology, University Hospitals Leuven
City	Leuven