cytomegalovirus-retinitis-audio

Cytomegalovirus (CMV) Retinitis usually occurs in immunocompromised patients e.g., those suffering from AIDS, on cytotoxic chemotherapy, or long term immuno-suppression following renal transplantation. It occurs only when CD 4 + counts < 50 cells mm3. However, since the advent of Highly Active Antiretroviral Therapy (HAART) there has occured a dramatic reduction in CMV retinitis.

Clinical features

Symptoms. Often asymtomatic, some patients may present with scotoma or decreased vision and/or floaters in one or both eyes.

Anterior Segment signs are ususally absent. Rarely few stellate KPs may be seen.

Posterior Segment signs include:

Haemorrhagic retinitis characterised by areas of necrosis (yellow white exudates) associated with areas of vasculitis (perivascular sheathing), retinal haemorrhages and loss of fundal details (pizza pie appearance) is a typical presentation in fulminant form of the disease. There occurs progressive retinal atrophy.
Grannular retinitis characterised by peripheral granular opacities with occasional haemorrhage seen in indolent form of the disease.
Complications include retinal detachment (up to 30%), retinal atrophy and optic nerve disease.
Treatment

HAART is recommended to reduce retroviral load and to increase CD4+ count in patients with AIDS .
Specific anti-CMV treatment includes: valaganciclovir, ganciclovir, foscarnet, and intravenous injections of cidofovir individually or in combination.

error: Content is protected !!

NEWNMCLE

NEWNMCLE