Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infectious / Inflammatory Disorders
Cytomegalovirus retinitis demonstrates characteristic confluent areas of retinal whitening and vascular sheathings along the vascular arcades.
Cytomegalovirus Retinitis

  • Most common ocular opportunistic infection in immunocompromised or immunosuppressed patients, i.e. patients with AIDS or organ transplant recipients
  • In AIDS patients, it usually seen in patients with CD4+ <50 per mm3
  • Clinical features:
    • Symptoms:
      • May be asymptomatic
      • Blurry or cloudy vision, floaters, light flashes, loss of central or peripheral vision
    • Signs:
      • Vitreous cells with mild anterior chamber inflammatory reaction
      • Indolent form: granular patches adjacent to retinal vessels with occasional hemorrhage
      • Fulminant form:
        • Confluent areas of retinal whitening associated with venous sheathing and hemorrhages along the major retinal vascular arcades
      • In both type, the leading edge of the infection will display irregular granular borders with small, isolated satellite lesions
      • Progressive retinal atrophy may complicate the infection
      • Rhegmatogenous retinal detachment may also occur
  • Workup:
    • Complete history and ocular examination
    • Serial fundus photograph to document progression
  • Management:
    • Medical management of the underlying systemic problem
    • Intravenous anti viral agents such as gancyclovir, cidofovir and foscarnet which may be used individually or in combination
    • Alternative intravitreal gancyclovir implant (the effect lasts in 6-10 months)

Copyright © 2003 Digital Reference of Ophthalmology. All rights reserved. All material published on this website is the property of Digital Reference of Ophthalmology and cannot be duplicated without permission.
Home Search Home Search