Cytomegalovirus Infection
- Systemic infection with cytomegalovirus
- May cause necrotizing retinitis as virus invades vascular endothelium
- At risk are immune-compromised patients and infants of HIV/AIDS-infected mothers
- Systemic and intravitreal antiviral treatment effective if given early
- Refer immune-compromised patients with visual symptoms, low CD4, high CMV viral loads, or cotton wool spots promptly to ophthalmologist
- Refer babies whose mothers have HIV/AIDS to ophthalmologist
- Immune reconstitution with highly active anti-retroviral therapy will be aimed at keeping CD4 count above 100/mm3
- Direct treatment options include ganciclovir, valganciclovir, foscarnet, cidofovir, and fomivirsen given systemically or intravitreally
- If started early enough, these treatments arrest infection and preserve vision
