CMV retinitis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[File:Fundus photograph-CMV retinitis EDA07.jpg|thumb|Fundus photograph of CMV retinitis]] | |||
*Signs/symptoms are variable; may include: | *Signs/symptoms are variable; may include: | ||
**Change in visual acuity | **Change in visual acuity | ||
Revision as of 01:54, 12 March 2015
Background
- Most frequent and serious ocular OI
- Leading cause of blindness in AIDS pts
- Typically occurs with CD4 less than 50
Diagnosis
- Signs/symptoms are variable; may include:
- Change in visual acuity
- Visual field cuts (Scotomas, loss of central vision)
- Floaters, flashing lights
- Photophobia
- Eye redness/pain
Complications
- Retinal detachment
- Complete Vision loss
- CMV Immune Recovery Uveitis (IRU)
- Patients with retinitis who develop blurry vision after starting HART need ophtho eval to assess for CMV progression, relapse, or IRU
- Possible cause - T-cell mediated immune reconstitution to latent CMV intraocular antigens
- Symptoms - Floaters, photophobia, blurred vision
- Occurs median 20 weeks after starting HART
- Urgent ophtho eval
Treatment
- Ganciclovir implant and ganciclovir 1–1.5gm PO TID
See Also
Source
Tintinalli
UpToDate - "Pathogenesis, clinical manifestations, and diagnosis of AIDS-related cytomegalovirus retinitis"