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Cytomegalovirus retinitis

Cytomegalovirus retinitis, also known as CMV retinitis, is an inflammation of the eye's retina that can lead to blindness.

Presentation
Cytomegalovirus (CMV) is a DNA virus in the family Herpesviridae known for producing large cells with nuclear and cytoplasmic inclusions. Such inclusions are called an "owl's eye" effect.

While CMV is found in almost everyone, and is usually fought off by the immune system, for people who are immunocompromised, by diseases, transplants, or chemotherapy the virus is not adequately destroyed and can cause damage to the eye and the rest of the body. HIV positive persons are most at risk, especially when the CD4 cell count decreases. CMV commonly becomes reactivated and can cause systemic infection in immunocompromised persons such as transplant patients or those infected by HIV.

It affects the eye in about 30% of the cases involving immunocompromised patients by causing damage to the retina. Symptoms can include blurred vision, eye pain, photophobia, redness, and blindness. It may affect just one eye at first, but then may spread to the other.

See retinal photograph of CMV retinitis for the appearance of CMV retinitis.
Treatment


Active Cytomegalovirus retinitis is treated by an uveitis and ocular immunology specialist.

Because the virus is so threatening to vision, it is usually treated by a vitreo-retinal surgeon, by antivirals such as ganciclovir or foscarnet, which can be taken orally, intravenously, injected directly into the eye (intravitreal injection), or through an intravitreal implant.

Aug 1998: Fomivirsen is the first antisense drug approved by the FDA (brand name Vitravene) as an intraocular injection for the treatment of cytomegalovirus retinitis.


Risk factorsThe systemic use of corticosteroids has recently been implicated as elevating the risk of CMV in AIDS patients.


http://en.wikipedia.org/wiki/Cytomegalovirus_retinitis