Presumed bilateral cytomegalovirus-induced optic neuropathy in an immunocompetent person. A case report.

Ocular manifestations of an acquired cytomegalovirus (CMV) infection are often associated with the patient being in an immunocompromised state. In the vast majority of cases, the affliction appears as a necrotic retinitis; an isolated optic nerve lesion is seen less frequently. To date, only two cases of CMV retinitis and one case of bilateral acute retinal necrosis have been reported in healthy individuals. We describe a 32-year-old healthy woman who developed bilateral papillitis. Tests were positive for acute CMV infection but negative for an immunocompromised state. We changed the antiviral therapy from acyclovir to foscarnet in association with corticosteroids, and resolution of the papillitis and recovery of visual acuity were obtained.