Normal retina vs cmv retinitis1/15/2024 ![]() ![]() When retinitis is inactive following anti-CMV treatment, the retina remains thin and atrophic with clumping of the pigment epithelium. 3ĬMV produces a characteristic ophthalmoscopic appearance of a pale, necrotic retina, often with focal areas of hemorrhage in a sectoral distribution spreading along vascular arcades. 1-4 CMV infection is a particular concern for certain patient populations because of the risk of infection to unborn babies, people who work with children and immunodeficient individuals, such as transplant recipients, cancer patients undergoing chemotherapy and those living with HIV.ĬMV retinitis occurs in patients who have failed to generate a primary T-cell response against the virus or who are carriers of CMV but whose previously effective CMV-specific T-cell response has decreased due to disease or immunosuppressive treatment. 1-3ĬMV disease can present with a wide range of manifestations, with colitis being the most common ( Table 1). Severe impairment of the immune system by medication or disease can reactivate the virus from its dormant or latent state. Initial infection, which may have few or even no symptoms, is followed by a prolonged period of infection during which the virus resides in cells without causing detectable damage or clinical illness. Like others in its viral family, CMV has a characteristic ability to remain dormant in the body over a long period. 2,3 CMV infects 50% to 85% of adults in the United States by age 40 and is also the virus most frequently transmitted to a child before birth. It can also be transmitted by organ transplantation. 3ĬMV is transmitted from person to person by breast milk, saliva or sexual contact. 3 Posterior segment findings may include an HIV-associated retinopathy/vasculopathy and a number of opportunistic infections of the retina and choroid. 2Īpproximately 80% of HIV-infected patients will be treated for an HIV-associated eye disorder. 1,2 A person’s CD4+ T-cell count reliably reflects their current risk of acquiring opportunistic infections. AIDS may also lead to secondary neoplasms, neurological manifestations and death. This patient diagnosed with AIDS presented with signs of CMV retinitis.ĪIDS, caused by the blood-borne retrovirus HIV, is characterized by profound immunosuppression that leads to opportunistic infections, including CMV. More recently, it has emerged as a cause of ocular and systemic sequelae in immunocompetent patients. 1,2 CMV is a large-enveloped, double-stranded member of the Herpesviridae family of DNA viruses.ĬMV gained recognition during the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic for causing infectious retinitis in susceptible patients. Humans are the primary host for eight herpes viruses: herpes simplex 1, herpes simplex 2, varicella-zoster, Epstein-Barr, Human herpesvirus-6, Human herpesvirus-7, Kaposi’s sarcoma herpes virus and cytomegalovirus (CMV), which is the cause of several diseases. Some patients are particularly susceptible to certain viruses, such as herpes. Viruses are ubiquitous pathogens that can have widespread effects on the body, including virtually all ocular tissues. ![]()
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