Epstein–Barr virus retinitis in an immunocompromised child: A case report

Introduction: The Epstein–Barr virus is a rare causative pathogen identified in the posterior segment. The majority of cases were presented with a serious condition of acute retinal necrosis, and most of these eyes had poor outcomes. The clinical features and effective treatment options for this condition are still unclear. Case description: A 10-year-old boy with leukaemia and receiving immunosuppressive regimen presented with decreasing visual acuity to counting fingers in his left eye for 2 weeks. Fundus examination revealed disc swelling, retinitis, retinal exudates and haemorrhages. Aqueous polymerase chain reaction was positive for Epstein–Barr virus DNA but negative for cytomegalovirus, herpes simplex virus and varicella zoster virus DNA. Systemic acyclovir and intravitreal ganciclovir injection were administered. Seven months later, retinitis resolved with remnant retinal fibrosis, and visual acuity improved to 20/500. Conclusion: Epstein–Barr virus is rarely identified as a sole pathogen in retinitis. Peripapillary predilection might be another type of presenting feature apart from the more-commonly reported peripheral acute retinal necrosis.