Retinitis

Daniel M. Albert, Amol D. Kulkarni

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

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.

Original languageEnglish (US)
Title of host publicationClinical Infectious Disease
PublisherCambridge University Press
Pages103-108
Number of pages6
ISBN (Electronic)9780511722240
ISBN (Print)9780521871129
DOIs
StatePublished - Jan 1 2010

ASJC Scopus subject areas

  • Medicine(all)

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    Albert, D. M., & Kulkarni, A. D. (2010). Retinitis. In Clinical Infectious Disease (pp. 103-108). Cambridge University Press. https://doi.org/10.1017/CBO9780511722240.015