II. Epidemiology

  1. Most common HIV ocular complication

III. Etiologies

  1. Most Common Retinitis Etiology
    1. Cytomegalovirus Chorioretinitis
  2. Other causes
    1. Varicella Zoster Virus
    2. Pneumocystis carinii
    3. Toxoplasma gondii

IV. Risks

  1. CD4 Count < 100
    1. Confers 20% CMV Retinitis risk in 2 years
    2. Usually occurs when CD4 Count < 50
  2. Invasive Cytomegalovirus confers 90% retinitis risk

V. Symptoms

  1. Vision changes (usually unilateral)
    1. Painless Blurred Vision
    2. Floaters in Visual Field
    3. Light Flashes
    4. Scotoma

VI. Signs: Focal Necrotizing Retinitis

  1. Retinal Hemorrhage, exudation, edema
  2. Opaque lesions with patchy Hemorrhage and Vasculitis
  3. Ischemic Retinopathy
    1. Cotton wool spots (areas of ischemic infarction)
    2. Usually no Hemorrhage or edema

VII. Course

  1. Disease progresses rapidly
    1. Irreversible blindness in 2 weeks if not treated
  2. Recurrence of CMV Retinitis
    1. Inevitable despite treatment (foscarnet, ganciclovir)
    2. Median 3-4 months (days-weeks without treatment)
    3. Ganciclovir implants may delay for 7 months

VIII. Complications

  1. Retinal Detachment with sudden loss of Vision

IX. Monitoring

  1. Ophthalmology exam every 6 months (CD4 Count <100/mm3)
  2. Ophthalmology exam every 3 months (CD4 Count <50/mm3)

X. Management

  1. Treat Retinitis immediately to prevent blindness
  2. See Cytomegalovirus for treatment

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Related Studies

Ontology: Cytomegalovirus Retinitis (C0206178)

Definition (MSHFRE) Infection de la rétine due au cytomégalovirus et caractérisée par une nécrose rétinienne, une hémorragie, une vascularite et un oedème rétinien. La rétinite à cytomégalovirus est une infection opportuniste retrouvée chez les patients ayant un SIDA . Elle peut être une cause de cécité.
Definition (CSP) opportunistic retinal herpes viral infection in AIDS.
Definition (MSH) Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness.
Concepts Disease or Syndrome (T047)
MSH D017726
SnomedCT 22455005
English Cytomegaloviral Retinitis, Retinitis, Cytomegalovirus, Cytomegalovirus Retinitis, Retinitis, Cytomegaloviral, CMV-Cytomegalovirus retinitis, cytomegalovirus retinitis, cytomegalovirus retinitis (diagnosis), Cytomegalovirus Retinitis [Disease/Finding], cmv retinitis, retinitis cmv, RETINITIS, CYTOMEGALOVIRAL, CYTOMEGALOVIRAL RETINITIS, CMV - Cytomegalovirus retinitis, CMV retinitis, Cytomegalovirus retinitis, Cytomegaloviral retinitis, Cytomegaloviral retinitis (disorder)
Dutch cytomegalovirusretinitis, CMV-retinitis, Cytomegalovirusretinitis, Retinitis, cytomegalovirus-
French Rétinite à Cytomégalovirus, Rétinite à CMV, Rétinite à cytomégalovirus
German Retinitis durch Zytomegalie-Virus, CMV Retinitis, Retinitis, Zytomegalievirus-, Zytomegalievirusretinitis
Italian Retinite da citomegalovirus, Retinite da Cytomegalovirus
Portuguese Retinite a citomegalovírus, Retinite por CMV, Retinite por Citomegalovirus
Spanish Retinitis por CMV, Retinitis por citomegalovirus, retinitis por CMV, retinitis citomegaloviral, retinitis citomegaloviral (trastorno), retinitis CMV, retinitis por citomegalovirus, retinitis por citomegalovirus (trastorno), Retinitis por Citomegalovirus
Swedish Cytomegalovirusretinit
Japanese サイトメガロウイルスセイモウマクエン, 網膜炎-サイトメガロウイルス性, サイトメガロウイルス性網膜炎, サイトメガロウイルス網膜炎, 網膜炎-サイトメガロウイルス
Czech cytomegalovirová retinitida, CMV retinitida, Cytomegalovirová retinitida
Finnish Sytomegalovirusretiniitti
Polish Zapalenie siatkówki cytomegaliawirusowe
Hungarian CMV retinitis, Cytomegalovirus retinitis
Norwegian Cytomegalovirusretinitt, Retinitt, cytomegalovirus