CMV retinitis is a sight-threatening viral infection of the retina, most often seen in people with severe immune suppression. It can cause progressive retinal necrosis and detachment if untreated.
Symptoms and risk groups
The condition is particularly associated with advanced HIV infection and some transplant or chemotherapy patients.
- Floaters, blurred vision, or scotomas that slowly expand
- Minimal pain but extensive retinal whitening and haemorrhages on examination
- Often asymptomatic until damage is advanced if peripheral
- Requires coordination between ophthalmology and infectious disease teams
Treatment
Prompt antiviral therapy is essential to limit damage.
- Intravenous or oral ganciclovir, valganciclovir, or related agents
- Intravitreal antiviral injections in some cases
- Restoration or optimisation of immune function, for example antiretroviral therapy
- Regular follow-up to monitor for progression, relapse, or detachment
