Optical Coherence Tomography Angiography Findings of Iris Ischemia and Reperfusion in Cytomegalovirus Panuveitis

Purpose: To report a case of iris ischemia in an eye affected by Cytomegalovirus (CMV)-related Chronic Retinal Necrosis (CRN) with partial reperfusion after antiviral therapy demonstrated by optical coherence tomography angiography (OCTA). Methods: Retrospective case report. Multimodal imaging was performed at each follow-up visits. Results: At baseline, the clinical findings and PCR on aqueous confirmed the diagnosis of CMV-induced CRN, while OCTA and Fluorescein Angiography showed multi-sectoral retinal and iris non-perfusion. After three weekly intravitreal injections of Foscarnet and retinal photocoagulation, the clinical and angiographic picture improved, with partial reperfusion of both retinal and iris vasculature. Conclusion: Retinal and iris non-perfusion in CRN can be partially reversible, if prompt treatment is administered. OCTA of the anterior segment allowed an accurate follow-up of the iris vasculature and its perfusion.