Cytomegalovirus retinitis, also known as CMV retinitis, is an inflammation of the retina of the human eye that can lead to blindness.
Signs and symptoms
The symptoms of cytomegalovirus retinitis have it usually starting in one eye (and also have the possibility of retinal detachment), presenting as:
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Cause
Cytomegalovirus (a type of herpes virus) is what causes cytomegalovirus retinitis. Other types of herpes viruses include herpes simplex viruses and Epstein-Barr virus. Once an individual is infected with these viruses they stay in the body for life.[. ]
Mechanism
Human cytomegalovirus (HCMV or CMV) is a DNA virus in the family Herpesviridae known for producing large cells with nuclear and cytoplasmic inclusions,
Those areas infected by cytomegalovirus have cells evolve to necrosis, though inflammation within the retina is not great.
Rhegmatogenous retinal detachments can occur following the development of holes in areas of healed retinitis (retina may be atrophic).
Diagnosis
The diagnosis of CMV retinitis can be done via the following:
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Ophthalmic screening frequency is based on CD4 count,(CD4 < 50 cells/mL, 0- 35% possibility of CMV retinitis)
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BUN
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CD8+ T-lymphocyte count
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CMV DNA capture ( polymerase chain reaction (PCR) test)
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DNA PCR ( ocular fluids)
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Viral load
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Complete blood count
Differential diagnosis
Another condition seen in AIDS patients that is similar and more common than CMV retinitis is HIV Retinopathy.
Treatment
In terms of the treatment of cytomegalovirus retinitis, oral valganciclovir, intravenous ganciclovir, IV foscarnet, and IV cidofovir are all efficient in the treatment of this condition. Also intravitreal injections, an injection of medicine into the vitreous near the retina, of foscarnet in concomitance with oral valganciclovir can be used for treatment as well.
Often individuals with CMV retinitis will need surgery for either retinal detachment or intravitreal instillation of ganciclovir. Retinal detachment occurs in up to 29% of affected eyes, repair being most effective with endolaser and silicone oil endotamponade.
Intravitreal ganciclovir implant has the benefit of less systemic toxicity. An adverse effect of this is retinal detachment (and vitreous hemorrhage), also there is no systemic beneficial effect for cytomegalovirus organ disease.[
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See also
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List of systemic diseases with ocular manifestations
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Progressive outer retinal necrosis
Further reading
External links
