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Diseases & Conditions: Cytomegalovirus
Overview
The cytomegalovirus (CMV) is related to the herpes virus
and is present in almost everyone. Normally, most people's
immune systems are able to fight the virus, preventing
it from causing problems in their bodies. However, when
the immune system is suppressed because of disease (HIV),
organ or bone marrow transplant, or chemotherapy, the CMV
virus can cause damage and disease to the eye and the rest
of the body.

Photographs of retinas affected with CMV retinitis.
CMV is the most common type of virus that infects those
who are HIV positive. It affects the eye in about 30% of
the cases by causing damage to the retina. This is called
CMV retinitis. The likelihood of developing CMV retinitis
increases as the CD4 cell count decreases.

Normal (unaffected) retina.
CMV retinitis may affect one eye at first, but usually
progresses to both eyes and becomes worse as the patient's
ability to fight infection decreases. The virus is sight
threatening and usually requires the care and treatment
of a vitreo-retinal surgeon. Patients with CMV retinitis
are at risk of retinal detachment, hemorrhages, and inflammation
of the retina that can lead to permanent loss of vision
and even blindness.
Signs & Symptoms
CMV retinitis usually causes symptoms, but not always.
Patients with a condition that suppresses the immune system
should watch for the following eye symptoms while under
the care of a physician.
- Floaters (spots, bugs, spider webs)
- Light flashes
- Blind spots
- Blurred vision
- Obstructed areas of vision
- Sudden decrease of vision
Detection & Diagnosis
Most patients with CMV retinitis are referred for eye
treatment by another physician. The vitreo-retinal surgeon
diagnoses CMV retinitis by thoroughly examining the back
of the eye using ophthalmoscopy. Fluorescein angiography
may be needed to evaluate the circulatory system of the
retina.
Treatment
When managing CMV retinitis, the doctor's goal is to slow
the progression of the disease and to treat related eye
problems. Anti-viral medications such as ganciclovir or
foscarnet are often prescribed. These drugs can be administered
orally, intravenously, injected directly into the eye or
through an intravitreal implant.
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