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Cytomegalovirus retinitis
Classification and external resources
ICD-10 B25.8, H30.9
ICD-9 078.5
eMedicine oph/701
MeSH D017726

Cytomegalovirus retinitis, also known as CMV retinitis, is an inflammation of the eye's retina that can lead to blindness.

Contents

Presentation

Cytomegalovirus (CMV) is a DNA virus in the family Herpesviridae known for producing large cells with nuclear and cytoplasmic inclusions. Such inclusions are called an "owl's eye" effect.

While CMV is found in almost everyone, and is usually fought off by the immune system, for people who are immunocompromised, by diseases, transplants, or chemotherapy the virus is not adequately destroyed and can cause damage to the eye and the rest of the body. HIV positive persons are most at risk, especially when the CD4 cell count decreases. CMV commonly becomes reactivated and can cause systemic infection in immunocompromised persons such as transplant patients or those infected by HIV.

It affects the eye in about 30% of the cases involving immunocompromised patients by causing damage to the retina. Symptoms can include blurred vision, eye pain, photophobia, redness, and blindness. It may affect just one eye at first, but then may spread to the other.

See retinal photograph of CMV retinitis for the appearance of CMV retinitis.

Treatment

Active Cytomegalovirus retinitis is treated by an uveitis and ocular immunology specialist.

Because the virus is so threatening to vision, it is usually treated by a vitreo-retinal surgeon, by antivirals such as ganciclovir or foscarnet, which can be taken orally, intravenously, injected directly into the eye (intravitreal injection), or through an intravitreal implant.

Fomivirsen is the first antisense drug approved by the FDA (brand name Vitravene) as an intraocular injection for the treatment of cytomegalovirus retinitis.

Risk factors

The systemic use of corticosteroids has recently been implicated as elevating the risk of CMV in AIDS patients.[1]

Associated conditions

The first report of CMV retinitis in a patient with dermatomyositis was recently published.[2]

References

  1. ^ Hodge WG, Boivin JF, Shapiro SH, Shah KC, Dionne MA (Dec 2005). "Iatrogenic risk factors for cytomegalovirus retinitis". Can J Ophthalmol. 40 (6): 701–10. PMID 16518896.  
  2. ^ Kim HR, Kim SD, Kim SH, et al. (May 2007). "Cytomegalovirus retinitis in a patient with dermatomyositis". Clin Rheumatol. 26 (5): 801–3. doi:10.1007/s10067-006-0239-9. PMID 16552465.  

See also

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