Cytomegalovirus
Overview
The
cytomegalovirus (CMV) is related to the
herpes virus and is present in almost
everyone. Normally,
most people’s immune systems are able to fight the virus, preventing
it from causing problems in their bodies.
However, when the immune system is suppressed because of
disease (HIV), organ or bone marrow transplant, or chemotherapy, the
CMV virus can cause damage and disease to the eye and the rest of
the body.
Photographs of retinas affected
with CMV retinitis
CMV is the most
common type of virus that infects those who are HIV positive.
It affects the eye in about 30% of the cases by causing
damage to the
retina. This is
called CMV retinitis.
The likelihood of developing CMV retinitis increases as the CD4
cell count decreases.
Normal (unaffected) retina
CMV retinitis
may affect one eye at first, but usually progresses to both eyes and
becomes worse as the patient's ability to fight infection decreases.
The virus is sight threatening and usually requires the care
and treatment of a vitreo-retinal surgeon.
Patients with CMV retinitis are at risk of
retinal detachment, hemorrhages,
and inflammation of the retina that can lead to permanent loss of
vision and even blindness.
Signs and Symptoms
CMV retinitis
usually causes symptoms, but not always.
Patients with a condition that suppresses the immune system
should watch for the following eye symptoms while under the care of
a physician.
·
Floaters (spots, bugs, spider webs)
·
Light flashes
·
Blind spots
·
Blurred vision
·
Obstructed areas
of vision
·
Sudden decrease
of vision
Detection and Diagnosis
Most patients
with CMV retinitis are referred for eye treatment by another
physician. The
vitreo-retinal surgeon diagnoses CMV retinitis by thoroughly
examining the back of the eye using
ophthalmoscopy.
Fluorescein
angiography may be needed to evaluate the circulatory system of
the retina.
Treatment
When managing
CMV retinitis, the doctor’s goal is to slow the progression of the
disease and to treat related eye problems.
Anti-viral medications such as ganciclovir or foscarnet are
often prescribed. These
drugs can be administered orally, intravenously, injected directly
into the eye or through an intravitreal implant.
St. Luke's Cataract & Laser
Institute provides this on-line information for educational and
communication purposes only and it should not be construed as
personal medical advice. Information published on this St.
Luke's website is not intended to replace, supplant, or augment a
consultation with an eye care professional regarding the
viewer/user's own medical care. St. Luke's disclaims any and
all liability for injury or other damages that could result from use
of the information obtained from this site.
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