Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- 11 Conjunctivitis
- 12 Keratitis
- 13 Iritis
- 14 Retinitis
- 15 Endophthalmitis
- 16 Periocular Infections
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
14 - Retinitis
from Part III - Clinical Syndromes – Eye
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- 11 Conjunctivitis
- 12 Keratitis
- 13 Iritis
- 14 Retinitis
- 15 Endophthalmitis
- 16 Periocular Infections
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
CYTOMEGALOVIRUS RETINITIS
Cytomegalovirus (CMV) retinitis is the most common and clinically significant opportunistic ocular infection seen in immunocompromised patients, including those with acquired immune deficiency syndrome (AIDS). With the extensive use of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-positive patients, there has been a tremendous decrease in the incidence of CMV retinitis in these patients (23 per 10 000 HIV/AIDS cases in the pre-HAART era to 8 per 10 000 HIV/AIDS cases in the post-HAART era).
The presentation of CMV retinitis may be unilateral or bilateral. The onset is insidious, and symptoms may include blurred vision, floaters, visual field defects, or other nonspecific visual complaints. Clinically, the various types of active chorioretinal lesions include (1) hemorrhagic pattern showing confluent area of full-thickness retinal necrosis with a yellow-white granular appearance and associated retinal hemorrhages, which has been referred to as a “pizza-pie” appearance (Figure 14.1); (2) “brush fire” pattern showing rapidly spreading zone of retinal necrosis with yellow-white margin; and (3) granular pattern showing areas of retinal atrophy amid white granular punctate lesions. In all of these, vitreous inflammation is minimal or absent. Visual loss may be profound if the macula or optic nerve (Figure 14.2) is involved. Without treatment, CMV retinitis will become bilateral in 80% of cases and eventually will result in blindness from retinal atrophy, retinal detachment, or optic nerve involvement.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 103 - 108Publisher: Cambridge University PressPrint publication year: 2008