HIV: Cytomegalovirus retinitis
Cytomegalovirus (CMV) retinitis is common, affecting 30-40% of patients who have a CD4 count < 50. Diagnosis is clinical as there are no diagnostic tests
Features
Fundoscopy
Management
Features
- visual impairment - 'blurred vision' etc
Fundoscopy
- characteristic appearance showing retinal haemorrhages and necrosis
- often called 'pizza' retina
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Fundus photograph showing CMV retinitis. Credit: National Eye Institute, National Institutes of Health
Management
- IV ganciclovir
- treatment used to be life-long but new evidence suggests that it may be discontinued once CD4 > 150 after HAART
- alternative: IV foscarnet or cidofovir