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{{Infobox medical condition (new)
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| ▲| causes = Bone marrow transplant, HIV/AIDS<ref name=nih/>
▲| risks =
| differential =
▲| diagnosis = Ophthalmologic exam, blood test<ref name=nih/>
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▲| medication = Antivirals (oral or intraocular injection)<ref name=pat/>
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'''Cytomegalovirus retinitis''', also known as '''CMV retinitis''', is an inflammation of the [[retina]] of the [[human eye|eye]] that can lead to [[blindness]].<ref name="nih">{{Cite
==Signs and symptoms==
[[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 | doi-access = free }}</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"/>]]
The symptoms of cytomegalovirus retinitis have it usually starting in one eye (and also have the possibility of retinal detachment), presenting
* [[Blurred vision]]
* [[Blind spot (vision)|Blind spots]]
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==Cause==
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
▲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 {{!}} CDC|website=www.cdc.gov|access-date=2016-03-16}}</ref> What triggers the virus to reactivate are the following (though CMV can also be congenital).<ref name="emed">{{Cite web|url=http://emedicine.medscape.com/article/1227228-clinical#b5|title=CMV Retinitis Clinical Presentation: History, Physical, Causes|website=emedicine.medscape.com|access-date=2016-03-16}}</ref>
* [[Leukemia]]
* [[AIDS]]
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==Mechanism==
[[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 |
Those areas infected by cytomegalovirus have cells evolve to [[necrosis]], though inflammation within the retina is not great.
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|
==Diagnosis==
[[File:Roland Gel.JPG|thumb|PCR result, Gel electrophoresis]]
The diagnosis of CMV retinitis can be done via the following:<ref name=emed/><ref>{{Cite book|url=https://books.google.com/books?id=vZxqM6cuQI4C|title=Diagnosis & Treatment of Uveitis|
* Ophthalmic screening frequency is based on [[CD4 count]],(CD4 < 50 cells/mL, 0- 35% possibility of CMV retinitis)
* BUN
* [[CD8+]] T-lymphocyte count
* CMV [[DNA]] capture ( polymerase chain reaction (PCR) test)
* DNA [[Polymerase chain reaction|PCR]] ( ocular fluids)
* [[Viral load]]
* Complete blood count
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==Treatment==
[[File:Ganciclovir ball-and-stick.png|thumb|Ganciclovir]]
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
Often individuals with CMV retinitis will need surgery for either [[retinal detachment]] or intravitreal instillation of ganciclovir. Retinal detachment occurs in up to 29% of affected eyes, repair being most effective with endolaser and [[silicone oil]] endotamponade.
Intravitreal ganciclovir implant has the benefit of less systemic toxicity. An adverse effect of this is retinal detachment (and vitreous hemorrhage), also there is no systemic beneficial effect for cytomegalovirus organ disease.<ref name=emed/>
== See also ==
* [[List of systemic diseases with ocular manifestations]]
* [[Progressive outer retinal necrosis]]
== References ==
{{Reflist}}
== Further reading ==
{{refbegin}}
* {{
* {{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}}
* {{
{{refend}}
== External links ==
* {{Cite web|url=https://nei.nih.gov/news/pressreleases/gipressrelease|title=Eye Implant Effective in Treating CMV Retinitis
{{Medical resources
| DiseasesDB =
| ICD10 = {{ICD10|B|25|8|b|25}}, {{ICD10|H|30|9|h|30}}
| ICD9 = {{ICD9|078.5}}
| ICDO =
| OMIM =
| MedlinePlus = 000665
| eMedicineSubj = oph
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{{Viral diseases}}
{{Eye pathology}}
{{Authority control}}
[[Category:HIV/AIDS]]
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