CMV retinitis

    • Cytomegalic inclusion disease
      • Congenital cytomegalic inclusion disease.
        • Ocular involvement
          • peripheral, central or total necrotizing chorioretinitis
          • with associated vitreous haze
          • Posterior pole is involved more commonly
      • Acquired cytomegalic inclusion disease.
        • occurs only in the immunosuppressed patients
        • CMV retinitis’ characterised by presence of
          • yellow-white exudates (areas of retinal necrosis)
          • associated with areas of vasculitis and retinal haemorrhages.
          • haemorrhagic retinal necrosis – sometimes described as ketchup (tomato sauce) on cottage cheese at the posterior pole (MCQ)
        • Some eyes may develop exudative retinal detachment.
        • Ultimately, there occurs total retinal atrophy
      • Treatment.
        • treatment with intravenous dihydroxy- propylmethyl guanine has been shown to cause regression in some cases.

    Better Treatment for CMV Retinitis, HIV-Related Illness, in Myanmar
    CMV retinitis strikes people with HIV and causes blindness if left untreated. The available treatment in Myanmar was painful – a weekly injection directly into the eye over a period of four to nine months for many years. It also failed to provide any protection against the other eye becoming infected, and it was extremely difficult to find staff skilled in administering the injection. An oral treatment has been available for years, but it was not available in Myanmar until recently. However the cost is still too high and it is not included in the World Health Organization guidelines.
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