CMV retinitis: Difference between revisions

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**Photophobia
**Photophobia
**Eye redness/pain
**Eye redness/pain
==Differential Diagnosis==
==Treatment==
*Ganciclovir implant and ganciclovir 1–1.5gm PO TID


==Complications==
==Complications==
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**Occurs median 20 weeks after starting HART
**Occurs median 20 weeks after starting HART
**Urgent ophtho eval
**Urgent ophtho eval
==Treatment==
*Ganciclovir implant and ganciclovir 1–1.5gm PO TID


==See Also==
==See Also==
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==Source==
==Source==
Tintinalli
*Tintinalli
 
*UpToDate - "Pathogenesis, clinical manifestations, and diagnosis of AIDS-related cytomegalovirus retinitis"
UpToDate - "Pathogenesis, clinical manifestations, and diagnosis of AIDS-related cytomegalovirus retinitis"


[[Category:ID]]
[[Category:ID]]
[[Category:Ophtho]]
[[Category:Ophtho]]

Revision as of 01:58, 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

Fundus photograph of CMV retinitis
  • 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

Differential Diagnosis

Treatment

  • Ganciclovir implant and ganciclovir 1–1.5gm PO TID

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

See Also

Source

  • Tintinalli
  • UpToDate - "Pathogenesis, clinical manifestations, and diagnosis of AIDS-related cytomegalovirus retinitis"