Adenoviral Retinitis: A Rare Case Presentation of a Common Virus

PURPOSE: To report a rare case of bilateral necrotising retinitis caused by a potentially novel human adenovirus D (HAdV-D) in a post-bone marrow transplant patient and to highlight the diagnostic challenges and therapeutic role of intravenous cidofovir, alongside a review of previously reported cases of human adenovirus (HAdV) retinitis. METHODS: Retrospective case report. RESULTS: was negative and the patient showed a poor response to multiple empirical antiviral therapies. This led to expanded PCR testing which detected high HAdV loads in both aqueous and vitreous samples. Genomic sequencing confirmed the presence of a potentially novel HAdV-D. The patient received intravenous cidofovir with close renal monitoring. Serial aqueous PCR demonstrated a substantial reduction in HAdV load, with corresponding clinical improvement and complete resolution of active retinitis, replaced by retinal scarring. Final best-corrected visual acuities were 0.4 LogMAR in the right eye and hand movements in the left eye. CONCLUSION: . Intravenous cidofovir may be an effective off-label treatment. A multidisciplinary approach is essential, and serial aqueous PCR is useful for monitoring treatment response.