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JAMA Ophthalmology Clinical Challenge
December 12, 2019

Subacute Vision Loss in a Patient With Limited Immune Dysfunction

Author Affiliations
  • 1Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2020;138(2):208-209. doi:10.1001/jamaophthalmol.2019.4915

A 62-year-old man presented with subacute, painless vision loss in the right eye that developed over the course of 1 week. He had a history of well-controlled type 2 diabetes and diffuse large B-cell lymphoma that was diagnosed 3 years earlier. The lymphoma was initially treated with chemotherapy, followed by a relapse that required additional chemotherapy and ultimately autologous bone marrow transplant 3 months before presentation. At the time of presentation, he was taking no immunosuppressive medications and was taking prophylactic acyclovir, 800 mg twice daily, and sulfamethoxazole/trimethoprim (800 mg/1600 mg) 3 times weekly.

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