Cytomegalovirus Retinitis Associated with Lenalidomide Use for Multiple Myeloma in an Immunocompetent Patient

Purpose. The aim of this report is to present a case of cytomegalovirus (CMV) retinitis in an immunocompetent patient using lenalidomide. Methods. Case report with fundus photography, spectral-domain optical coherence tomography, and fluorescein angiography imaging. Results. A 55-year-old male with history of multiple myeloma treated with lenalidomide presented with blurriness and floaters in his right eye and was found to have vitreous biopsy-confirmed CMV retinitis. The patient was treated with pars plana vitrectomy, oral valganciclovir, and intravitreal foscarnet. More than one year later, the patient was doing well with visual acuity of 20/25 and no recurrence of retinitis. Conclusion. This represents the second report of CMV retinitis associated with lenalidomide therapy. It suggests that even immunocompetent patients can be affected by CMV retinitis in the context of lenalidomide treatment. It is critical that patients being treated with lenalidomide receive prompt evaluation if they develop ophthalmic symptoms.