View source for CMV retinitis

==Background==
*Most frequent and serious ocular opportunistic infection
*Leading cause of blindness in [[AIDS]] patients
*Typically occurs with CD4 less than 50

==Clinical Features==
[[File:Fundus photograph-CMV retinitis EDA07.jpg|thumb|Fundus photograph of CMV retinitis]]
*Variable, but may include:
**Change in visual acuity, [[visual loss]]
**[[visual field defects|Visual field cuts]] (Scotomas, loss of central vision)
**[[Floaters]], flashing lights
**Photophobia
*[[Fundoscopy]]:
**Fluffy white perivascular lesions
**Dirty white granular retinal necrosis
**Adjacent hemorrhage - "Pizza pie" appearance

**[[Eye pain]]/[[red eye|redness]]

==Differential Diagnosis==
{{Acute onset flashers and floaters DDX}}

{{HIV associated conditions}}

==Evaluation==
*CD4 typically < 50 cells/mm³

==Management==
===Antivirals===
{{CMV retinitis treatment}}

==Complications==
*[[Retinal detachment]]
*Complete [[vision loss]]
**Despite treatment, 10% lose vision
*CMV Immune Recovery Uveitis (IRU)
**Patients with retinitis who develop blurry vision after starting HAART 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 HAART
**Urgent ophtho eval

==Disposition==

==See Also==
*[[HIV - AIDS (Main)]]
*[[Cytomegalovirus (CMV) infection]]

==References==
<References/>
*Rothmans RE, Marco CA, Yang S. Human immunodeficiency virus infection and acquired immunodeficiency syndrome, in Tintinalli JE, Stapczynski JS, Ma OJ, et al (eds): Tintinalli’s Emergency Medicine, ed 7. New York, The McGraw-Hill Companies Inc., 2011.
[[Category:ID]]
[[Category:Ophthalmology]]