CMV retinitis: Difference between revisions
| Line 8: | Line 8: | ||
**Change in visual acuity | **Change in visual acuity | ||
**Visual field cuts (Scotomas, loss of central vision) | **Visual field cuts (Scotomas, loss of central vision) | ||
**Floaters, | **Floaters, flashing lights | ||
**Photophobia | **Photophobia | ||
**Eye redness/pain | **Eye redness/pain | ||
==Complications== | |||
*Retinal detachment | |||
*Complete Vision loss | |||
*CMV Immune Recovery Uveitis (IRU) | |||
**Patients with retinitis who develop blurry vision after starting HART need ophtho eval to assess for CMV progression, relapse, or IRU | |||
**Possible cause - T-cell mediated immune reconstitution to latent CMV intraocular antigens | |||
**Symptoms - Floaters, photophobia, blurred vision | |||
**Occurs median 20 weeks after starting HART | |||
**Urgent ophtho eval | |||
==Treatment== | ==Treatment== | ||
Revision as of 20:52, 11 March 2015
Background
- Most frequent and serious ocular OI
- Leading cause of blindness in AIDS pts
- Typically occurs with CD4 less than 50
Diagnosis
- Signs/symptoms are variable; may include:
- Change in visual acuity
- Visual field cuts (Scotomas, loss of central vision)
- Floaters, flashing lights
- Photophobia
- Eye redness/pain
Complications
- Retinal detachment
- Complete Vision loss
- CMV Immune Recovery Uveitis (IRU)
- Patients with retinitis who develop blurry vision after starting HART need ophtho eval to assess for CMV progression, relapse, or IRU
- Possible cause - T-cell mediated immune reconstitution to latent CMV intraocular antigens
- Symptoms - Floaters, photophobia, blurred vision
- Occurs median 20 weeks after starting HART
- Urgent ophtho eval
Treatment
- Ganciclovir implant and ganciclovir 1–1.5gm PO TID
See Also
Source
Tintinalli