Cytomegalovirus retinitis: Difference between revisions

[[File:PMID20029144 06 cytomegalovirus retinitis - pizza pie.png|thumb|The typical "pizza pie" appearance of the fundus in CMV retinitis<ref name="JAMA">{{cite journal | vauthors = To K, Friedman AH | title = Cytomegalovirus retinitis | journal = JAMA | issn = 0098-7484 | volume = 262 | issue = 23 | pages = 3337 | date = December 1989 | pmid = 2555576 | doi = 10.1001/jama.1989.03430230122038 | url = https://jamanetwork.com/journals/jama/article-abstract/379907 | url-access = subscription }}</ref><ref>{{cite journal | vauthors = Sudharshan S, Ganesh SK, Biswas J | title = Current approach in the diagnosis and management of posterior uveitis | journal = Indian Journal of Ophthalmology | issn = 0301-4738 | volume = 58 | issue = 1 | pages = 29–43 | date = January 2010 | pmid = 20029144 | pmc = 2841371 | doi = 10.4103/0301-4738.58470 | url = https://journals.lww.com/ijo/Fulltext/2010/58010/Current_approach_in_the_diagnosis_and_management.5.aspx | archivedoi-urlaccess = https://archive.ph/iDUaj | archive-date = 6 March 2023free }}</ref><ref>{{cite magazine|magazine=EyeNet Magazine - [[American Academy of Ophthalmology]]|title=HIV-Related CMV Retinitis in the Developing World|url=https://www.aao.org/Assets/6b1e694e-62d6-4fa3-9691-dc7a2f7cb9dc/635559897697170000/february-2014-clinical-update-international-pdf|archive-url=https://web.archive.org/web/20230307073536/https://www.aao.org/Assets/6b1e694e-62d6-4fa3-9691-dc7a2f7cb9dc/635559897697170000/february-2014-clinical-update-international-pdf|archive-date=2023-03-07|format=PDF|archive-format=PDF| vauthors = Weiner G |pages=27–29|date=February 2014}}</ref><ref name="emed"/>]]

Cytomegalovirus (a type of [[herpes]] virus) is what causes cytomegalovirus retinitis. Other types of herpes viruses include [[herpes simplex]] viruses and [[Epstein-Barr virus]]. Once an individual is infected with these viruses they stay in the body for life.<ref>{{Cite web|url=https://www.cdc.gov/cmv/overview.html|title=CMV {{!}} Overview {{!}} Cytomegalovirus and Congenital CMV Infection | publisher = U.S. Centers for Disease Control and Prevention |access-date=2016-03-16}}</ref> What triggers the virus to reactivate are the following (though CMV can also be congenital).<ref name="emed">{{emedicine|article|1227228|Cytomegalovirus (CMV) Retinitis|clinical}}. {{webarchiveCite web |url=https://archiveemedicine.phmedscape.com/NDbRHarticle/1227228-clinical |title=Archived copy |access-date=8 September 2023 |archive-date=7 MarMarch 2023 |nolinkarchive-url=1https://archive.today/20230307081606/https://emedicine.medscape.com/article/1227228-clinical |url-status=bot: unknown }}</ref>

[[Human cytomegalovirus]] (HCMV or CMV) is a [[DNA virus]] in the family ''[[Herpesviridae]]'' known for producing large cells with nuclear and cytoplasmic inclusions,<ref>{{Cite book | vauthors = Ray K, Bala M | chapter = Human Cytomegalovirus Infection |url=https://books.google.com/books?id=kQ9tAwAAQBAJ|title=Sexually Transmitted Infections | vauthorsedition = 2nd | veditors = Kumar B, Gupta S |date= February 2014-02-10 |publisher=Elsevier Health Sciences|page=399|isbn=978-8-131-22978-1 |language=en}}</ref> CMV infects around 40% of the population worldwide.<ref>{{cite book |vauthors=Offermanns S, Rosenthal W | title = Encyclopedia of Molecular Pharmacology |url=https://archive.org/details/encyclopediamole12rose |url-access=limited | edition = 2nd | pages = [https://archive.org/details/encyclopediamole12rose/page/n459 437]–438 | publisher = Springer | year = 2008 | isbn = 978-3-540-38916-3 }}</ref>

Rhegmatogenous retinal detachments can occur following the development of holes in areas of healed retinitis (retina may be [[atrophic]]).<ref>{{Cite web | vauthors = Wu L, Pakalnis VA | date = 8 October 2019 | veditors = Law SK, Charles S, Dahl AA |url=http://emedicine.medscape.com/article/1224737-clinical#b5|title=Rhegmatogenous Retinal Detachment Clinical Presentation: History, Physical, Causes| work = Medscape |access-date=2016-03-16}}</ref><ref>{{cite journal | vauthors = Cheeran MC, Lokensgard JR, Schleiss MR | title = Neuropathogenesis of congenital cytomegalovirus infection: disease mechanisms and prospects for intervention | journal = Clinical Microbiology Reviews | issn = 0893-8512 | volume = 22 | issue = 1 | pages = 99–126, Table of Contents | date = January 2009 | pmid = 19136436 | pmc = 2620634 | doi = 10.1128/CMR.00023-08 }}</ref> [[Proliferative vitreoretinopathy]] has been observed in cases of retinal detachment.<ref>{{cite journal | vauthors = Sadaka A, Giuliari GP | title = Proliferative vitreoretinopathy: current and emerging treatments | journal = Clinical Ophthalmology | issn = 1177-5467 | volume = 6 | pages = 1325–1333 | date = January 2012 | pmid = 22942638 | pmc = 3429288 | doi = 10.2147/OPTH.S27896 | doi-access = free }}</ref>

In terms of the treatment of cytomegalovirus retinitis, oral [[valganciclovir]], intravenous [[ganciclovir]], IV [[foscarnet]], and IV [[cidofovir]] are all efficient in the treatment of this condition. Also intravitreal injections, an injection of medicine into the vitreous near the retina, of [[foscarnet]] in concomitance with oral valganciclovir can be used for treatment as well.<ref>{{Cite web|url=https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/337/cmv|title=Cytomegalovirus Disease {{!}} Adult and Adolescent OI Prevention and Treatment Guidelines {{!}}| work = AIDSinfo |website publisher =AIDSinfo U.S. National Institutes of Health |access-date=2016-03-16|archive-date=2016-03-23|archive-url=https://web.archive.org/web/20160323165559/https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/337/cmv|url-status=dead}}</ref><ref name="pat">{{Cite web | vauthors = Tidy C | date = 12 March 2014 | veditors = Huinsn H |url=http://patient.info/doctor/inflammatory-retinal-diseases|title=Inflammatory Retinal Diseases. |language=en-GB|access-date=2016-03-16 | work = Patient | publisher = Egton Medical Information Systems Limited | location = Leeds, UK }}</ref><ref>{{Cite encyclopedia |url= https://www.nlm.nih.gov/medlineplus/ency/article/007629.htm |title=Intravitreal injection| encyclopedia = MedlinePlus Medical Encyclopedia| publisher = U.S. National Library of Medicine |access-date=2016-03-16}}</ref>

* {{cite journal | vauthors = Ljungman P, Griffiths P, Paya C | title = Definitions of cytomegalovirus infection and disease in transplant recipients | journal = Clinical Infectious Diseases | issn = 1058-4838 | volume = 34 | issue = 8 | pages = 1094–1097 | date = April 2002 | pmid = 11914998 | doi = 10.1086/339329 | doi-access = free }}

* {{cite journal | vauthors = Heiden D, Ford N, Wilson D, Rodriguez WR, Margolis T, Janssens B, Bedelu M, Tun N, Goemaere E, Saranchuk P, Sabapathy K, Smithuis F, Luyirika E, Drew WL | display-authors = 6 | title = Cytomegalovirus retinitis: the neglected disease of the AIDS pandemic | journal = PLOS Medicine | issn = 1549-1676 | volume = 4 | issue = 12 | pages = e334 | date = December 2007 | pmid = 18052600 | pmc = 2100142 | doi = 10.1371/journal.pmed.0040334 | doi-access = free }} {{open access}}

* {{cite journal | vauthors = Campbell RJ, Chow B, Victor G, Kravcik S, Hodge WG | title = Treatment of CMV retinitis with intravitral ganciclovir in the HAART era | journal = The Canadian Journal of Infectious Diseases =| Journalissn Canadien des Maladies= Infectieuses1180-2332 | volume = 12 | issue = 5 | pages = 300–304 | date = September 2001 | pmid = 18159353 | pmc = 2094829 | doi = 10.1155/2001/851845 | doi-access = free }}

* {{Cite web|url=https://nei.nih.gov/news/pressreleases/gipressrelease|title=Eye Implant Effective in Treating CMV Retinitis | work = National Eye Institute |access-date=2016-03-17|archive-date=2015-09-10|archive-url=https://web.archive.org/web/20150910024531/https://nei.nih.gov/news/pressreleases/gipressrelease|url-status=dead}}