Cytomegalovirus retinitis (CMV retinitis) is a serious viral eye infection of the retina, the light-sensing nerve layer that lines the back of the eye. It is most often found in people with compromised immune systems.
Cytomegalovirus Retinitis Causes
CMV retinitis is caused by the cytomegalovirus, one of the herpes viruses that infects the majority of adults. Most people have been exposed to the virus, but the vast majority of people who have cytomegalovirus have no symptoms of infection and will not have any problems because of the virus. However, in people with compromised immune systems, the virus can reactivate and spread to the retina through the bloodstream, leading to vision-threatening eye problems. In older adults with weaker immune systems, the retinal damage can occur when the virus spreads from shingles on the forehead and nose.
Cytomegalovirus Retinitis Symptoms
CMV retinitis symptoms can begin with a slow onset of floaters with blurred vision over a few days. Often these symptoms progress to loss of peripheral (side) vision. Sometimes the symptoms begin in the center of vision with a blind spot that can progress to loss of central vision. The symptoms usually occur first in one eye but often progress to the other eye. Without treatment or improvement in the immune system, CMV retinitis destroys the retina, the light-sensitive tissue lining the back of the eye, and damages the optic nerve, which results in blindness. People with CMV retinitis will often develop a detached retina.
Who Is At Risk for Cytomegalovirus Retinitis?
CMV retinitis is a significant threat to other people with weak immune systems, such as newborns, the elderly, people undergoing chemotherapy, and recipients of organ transplants. Because CMV retinitis does not cause symptoms in the early stages, people with compromised immune systems should be monitored closely by an ophthalmologist (Eye M.D.)for the disease.
HIV, AIDS and cytomegalovirus retinitis
Before the introduction of highly active antiretroviral therapy, CMV retinitis was a common problem for people with AIDS. While it is less common now, people with HIV or AIDS still have a higher risk for CMV retinitis. People with HIV or AIDS should see an Eye M.D. regularly to check for signs of CMV retinitis.
Cytomegalovirus Retinitis Diagnosis
Your ophthalmologist (Eye M.D.) can make a CMV retinitis diagnosis by giving you a dilated eye examination. In this examination, dilating eye drops will be placed in your eyes to dilate, or enlarge, your pupils. During this painless examination, your Eye M.D. will be able to carefully observe areas of your eye, including your retina for signs of CMV retinitis.
Cytomegalovirus Retinitis Treatment
Strengthening your immune system is an important part of treating CMV retinitis. People with HIV or AIDS often see an improvement if they are on highly active antiretroviral therapy (HAART).
There are also specific CMV retinitis treatments. Ganciclovir and other antiviral medicines are available, and they can be administered orally (by mouth), intravenously (through a vein), as an intraocular injection (injection in the eye), and, in some cases, via an implant in the eye that delivers medication over time. Often laser surgery is needed to strengthen the retina where CMV damage has occurred.
Although treatments are available, vision lost because of CMV retinitis cannot be regained, and even with treatment, the disease may still progress. Recurrence of CMV retinitis is common, so regular checkups with an ophthalmologist (Eye M.D.) are important.