Bilateral Frosted Branch Angiitis in a young boy: A Case Report

Background: Cytomegalovirus (CMV) retinitis is a necrotizing viral infection typically affecting immunocompromised individuals. Its association with frosted branch angiitis (FBA), a rare retinal vasculitis pattern, is uncommon and rarely reported in immunocompetent children. Case Summary: A 10-year-old immunocompetent boy presented with sudden bilateral vision loss, with visual acuity of counting fingers at 1 feet (right eye) and hand movements (left eye). Fundus examination showed bilateral FBA with dense perivascular sheathing, retinal hemorrhages, and severe macular edema. By positive CMV serology, with exclusion of other causes, he was diagnosed as Bilateral FBA due to presumptive CMV Retinitis . He was treated with oral valganciclovir, intravitreal ganciclovir, and oral prednisolone under antiviral cover, achieving marked visual improvement to 6/12 (right eye) and 6/18 (left eye) with resolution of retinal findings. Conclusion: CMV retinitis should be considered a treatable infectious cause of FBA even in immunocompetent children. Early recognition and prompt antiviral therapy are key to favorable visual outcomes in this potentially blinding condition. J.Natl.Inst.Ophthalmol.2025;8(1): 71-74