Cytomegalovirus retinitis
Cytomegalovirus retinitis | |
---|---|
Other names | CMV retinitis |
Fundus photograph of CMV retinitis | |
Specialty | Ophthalmology, infectious diseases |
Symptoms | Blurred vision[1] |
Causes | Bone marrow transplant, HIV/AIDS[1] |
Diagnostic method | Ophthalmologic exam, blood test[1] |
Medication | Antivirals (oral or intraocular injection)[2] |
Cytomegalovirus retinitis, also known as CMV retinitis, is an inflammation of the
Signs and symptoms
The symptoms of cytomegalovirus retinitis have it usually starting in one eye (and also have the possibility of retinal detachment), presenting as:[1]
- Blurred vision
- Blind spots
- Specks in your vision
Cause
Cytomegalovirus (a type of
- Leukemia
- AIDS
- Immunosuppressive chemotherapy
Mechanism
Those areas infected by cytomegalovirus have cells evolve to necrosis, though inflammation within the retina is not great. Rhegmatogenous retinal detachments can occur following the development of holes in areas of healed retinitis (retina may be
Diagnosis
The diagnosis of CMV retinitis can be done via the following:[7][14]
- Ophthalmic screening frequency is based on CD4 count,(CD4 < 50 cells/mL, 0- 35% possibility of CMV retinitis)
- BUN
- CD8+T-lymphocyte count
- CMV DNA capture ( polymerase chain reaction (PCR) test)
- DNA PCR ( ocular fluids)
- Viral load
- Complete blood count
Treatment
In terms of the treatment of cytomegalovirus retinitis, oral valganciclovir, intravenous ganciclovir, IV foscarnet, and IV cidofovir are all efficient in the treatment of this condition. Also intravitreal injections, an injection of medicine into the vitreous near the retina, of foscarnet in concomitance with oral valganciclovir can be used for treatment as well.[15][2][16]
Often individuals with CMV retinitis will need surgery for either retinal detachment or intravitreal instillation of ganciclovir. Retinal detachment occurs in up to 29% of affected eyes, repair being most effective with endolaser and silicone oil endotamponade. Intravitreal ganciclovir implant has the benefit of less systemic toxicity. An adverse effect of this is retinal detachment (and vitreous hemorrhage), also there is no systemic beneficial effect for cytomegalovirus organ disease.[7]
See also
References
- ^ a b c d e "Cytomegalovirus retinitis". MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Retrieved 2016-03-14.
- ^ a b Tidy C (12 March 2014). Huinsn H (ed.). "Inflammatory Retinal Diseases". Patient. Leeds, UK: Egton Medical Information Systems Limited. Retrieved 2016-03-16.
- ISBN 978-9-351-52097-9.
- PMID 2555576.
- PMID 20029144.
- ^ Weiner G (February 2014). "HIV-Related CMV Retinitis in the Developing World" (PDF). EyeNet Magazine - American Academy of Ophthalmology. pp. 27–29. Archived from the original (PDF) on 2023-03-07.
- ^ a b c d Cytomegalovirus (CMV) Retinitis~clinical at eMedicine. "Archived copy". Archived from the original on 7 March 2023. Retrieved 8 September 2023.
{{cite web}}
: CS1 maint: archived copy as title (link) CS1 maint: bot: original URL status unknown (link) - ^ "CMV | Overview | Cytomegalovirus and Congenital CMV Infection". U.S. Centers for Disease Control and Prevention. Retrieved 2016-03-16.
- ISBN 978-8-131-22978-1.
- ISBN 978-3-540-38916-3.
- ^ Wu L, Pakalnis VA (8 October 2019). Law SK, Charles S, Dahl AA (eds.). "Rhegmatogenous Retinal Detachment Clinical Presentation: History, Physical, Causes". Medscape. Retrieved 2016-03-16.
- PMID 19136436.
- PMID 22942638.
- ISBN 978-9-350-25572-8.
- ^ "Cytomegalovirus Disease | Adult and Adolescent OI Prevention and Treatment Guidelines". AIDSinfo. U.S. National Institutes of Health. Archived from the original on 2016-03-23. Retrieved 2016-03-16.
- ^ "Intravitreal injection". MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Retrieved 2016-03-16.
Further reading
- Ljungman P, Griffiths P, Paya C (April 2002). "Definitions of cytomegalovirus infection and disease in transplant recipients". Clinical Infectious Diseases. 34 (8): 1094–1097. PMID 11914998.
- Heiden D, Ford N, Wilson D, Rodriguez WR, Margolis T, Janssens B, et al. (December 2007). "Cytomegalovirus retinitis: the neglected disease of the AIDS pandemic". PLOS Medicine. 4 (12): e334. PMID 18052600.
- Campbell RJ, Chow B, Victor G, Kravcik S, Hodge WG (September 2001). "Treatment of CMV retinitis with intravitral ganciclovir in the HAART era". The Canadian Journal of Infectious Diseases. 12 (5): 300–304. PMID 18159353.
External links
- "Eye Implant Effective in Treating CMV Retinitis". National Eye Institute. Archived from the original on 2015-09-10. Retrieved 2016-03-17.