Risk factors, diagnosi̇s and treatment of cytomegalovirus retinitis

Aim: To evaluate the treatment outcomes and prognosis of patients with cytomegalovirus (CMV) retinitis Method: We reviewed the charts of patients with CMV retinitis who were seen at the Uveitis Service of the Department of Ophthalmology, Istanbul University Istanbul Faculty of Medicine between 2009 and 2019. Complaints at the time of admission, family history, topical and systemic medication history were noted at the first visit. The best-corrected visual acuity (BCVA), intraocular pressure and anterior chamber flare measurement of the patients were recorded at each visit. Fundus images taken at the begining of follow-up were evaluated by two independent observers for the localization of the retinitis and the ratio of the retinal involvement to the entire retina. The clinical findings of HIV and non-HIV groups were compared. Results: Forty-seven eyes of 33 patients were included in the study. Seven patients (21.2%) were female and 26 (78.8%) were male. While HIV was positive in eight patients (24.2%) various other predisposing conditions were found in the rest of them (n=25, 75.8%). While location, exten and type of CMV retinitis were similar in HIV positive and negative patients, vitreous haze was more common in the latter group. Initial BCVA was worse in eyes with CMV retinitis involving more than 25% of the retina. The only factor affecting the final BCVA was the initial BCVA. In 76,9% eyes retinitis resolved within 5 weeks after initiation of antiviral treatment. The mean flare in the first month was significantly lower than the mean flare at first visit. There was no difference between the two groups in mean BCVA at the time of diagnosis and the last visit. In addition, immune recovery uveitis (IRU) was detected in both groups. Conclusion: CMV retinitis may present with various findings in HIV infected and uninfected patients. The area of retinal involvement is the most important factor determining visual outcome. IRU may complicate the course in all cases