Choriocapillaris Loss in a Pediatric Patient With Congenital Cytomegalovirus Seen on Optical Coherence Tomography Angiography

Purpose: To describe choriocapillaris loss on optical coherence tomography angiography (OCTA) imaging in a pediatric patient with congenital cytomegalovirus (CMV). Methods: A case was evaluated. Results: A 7-year-old female patient was referred for retinal evaluation of maculopathy in the right eye. She was diagnosed with congenital CMV at 14 months of age, at which time treatment was not deemed necessary. At 7 years of age, the patient was asymptomatic with 20/20 Snellen visual acuity. Funduscopy and colored fundus photographs showed macular scarring. Ancillary testing was performed, with retinal pigment epithelium alterations and disruption of the outer retinal layers seen on OCT and choriocapillaris loss in the area of the macular scar seen on OCTA. Conclusions: For patients with congenital CMV, OCTA imaging can show significant changes in choriocapillaris function. These changes do not necessarily correlate with visual function parameters. OCTA may be useful as an additional screening or surveillance modality for patients with congenital CMV or CMV retinitis.