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14 - Retinitis

from Part III - Clinical Syndromes – Eye

Published online by Cambridge University Press:  05 March 2013

Daniel M. Albert
Affiliation:
University of Wisconsin School of Medicine and Public Health
Amol D. Kulkarni
Affiliation:
University of Wisconsin School of Medicine and Public Health
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
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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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Publisher: Cambridge University Press
Print publication year: 2008

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  • Retinitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.015
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  • Retinitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.015
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Retinitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.015
Available formats
×