What is Cytomegalovirus (CMV) Retinitis: Symptoms, Causes and Treatment



Cytomegalovirus (CMV) retinitis is a serious viral eye infection of the Retina (light-sensing nerve layer that lines the back of the eye). This is a kind of sight-threatening condition associated with AIDS- a serious disease of the immune system due to infection with the human immunodeficiency virus.

In the past, about a quarter of active AIDS patients developed Cytomegalovirus (CMV) retinitis. However, the occurrence of the disease is dropping dramatically, thanks to a potent combination of medicines used for the treatment of HIV/AIDS that help restore the function of the immune system. In recent years, these medicines have helped reduce the presence of CMV retinitis in late-stage AIDS by more than 80 %, as per a report.

CMV Retinitis Signs/Symptoms:

When Cytomegalovirus invades the retina, it starts to compromise the light-sensitive receptors that help enable us to see. This typically does not cause any kind of pain, but you may notice eye floaters or small specks and experience decreased visual acuity (blurry vision) or reduced peripheral vision.

Light flashes (spots of light that you notice in your field of vision) and sudden vision loss also can arise. CMV retinitis usually starts in one eye but often progresses to the other eye. Without treatment, the disease can cause a detached retina and blindness in just 2-6 months.

Patients with HIV/AIDS sometimes also experience changes to the retina and optic nerve without clear signs and symptoms of Cytomegalovirus (CMV) retinitis.

Causes of CMV Retinitis:

Cytomegalovirus: a very common virus that belongs to the herpes family is responsible for CMV retinitis. Approximately 80 % of adults harbor antibodies to CMV, which represents that they have been infected with the virus but their bodies have effectively fought it off.

For individuals with HIV/AIDS, the difference is that their immunocompromised or non-functioning immune system cannot stave off this virus. Other individuals with an immunocompromised, weakened immune system or suppressed immune system, such as all those undergoing chemo or a bone marrow transplant, also are at risk. The disease occurs much less frequently in this population than in the AIDS population.

Also, in older individuals with weaker immune systems, the Cytomegalovirus can spread from a shingles infection on the forehead or nose and infect the retina, causing Cytomegalovirus retinitis.

CMV Retinitis Treatment:

If someone with active HIV/AIDS and is experiencing visual symptoms, see a retina specialist promptly. An individual newly diagnosed with Cytomegalovirus retinitis can expect to visit the specialist every 2 to 4 weeks.

Medicines for CMV Retinitis: The anti-viral medicines commonly used for the treatment of CMV retinitis are foscarnet (Foscavir), ganciclovir (Cytovene), and cidofovir (Vistide). They are very effective in order to slow down the progression of the disease.

Like many medicines, these treatments can be responsible for causing unwanted and severe side effects. Until recently, all these three medicines were given intravenously, and ganciclovir and foscarnet sodium required an indwelling catheter placed in the chest for daily infusions.

The medicine Ganciclovir is now supplied as a pill and oral doses usually are recommended after 2 weeks of intravenous infusion. It also can be given via an intravitreal implant named Vitrasert (Bausch + Lomb).

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