Opportunistic infections of the retina in patients with aquaporin-4 antibody disease

Jithin S. George, Maria Isabel Leite, Joanna L. Kitley, Nicola Jones, Nicholas Cortes, Matthew Donati, Bethan Non Matthews, Daniel Calladine, Charles Hillier, Imran H. Yusuf, Robert Munneke, Chetan K. Patel, Jacqueline A. Palace, John S. Elston*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

IMPORTANCE: Patients with neuromyelitis optica who have aquaporin-4 antibodies are being identified and receiving immunosuppressant treatment earlier and more aggressively as a result of increasing awareness of the importance of preventing relapses responsible for the high morbidity and mortality associated with the disease. To our knowledge, opportunistic retinal infection in patients with aquaporin-4 antibodies who are receiving immunosuppressants has not been reported to date. OBSERVATIONS: We describe 2 patients with aquaporin-4 antibodies who were receiving conventional doses of first-line immunosuppressive therapy. Both patients presented with vision loss that was initially thought to be optic neuritis attacks. The subsequent diagnoses were ocular toxoplasmosis and cytomegalovirus retinitis. CONCLUSIONS AND RELEVANCE: Retinal opportunistic infections can occur in patients with aquaporin-4 antibodies who are receiving relatively low levels of immunosuppression, may mimic optic neuritis, and are a potentially reversible cause of vision loss when treated promptly.

Original languageEnglish
Pages (from-to)1429-1432
Number of pages4
JournalJAMA Neurology
Volume71
Issue number11
DOIs
Publication statusPublished - 1 Nov 2014

Bibliographical note

Publisher Copyright:
Copyright 2014 American Medical Association. All rights reserved.

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