To study the characteristics, clinical course and visual outcome for cytomegalovirus (CMV) retinitis in patients of a tertiary referral ophthalmology clinic

Retrospective cross-sectional study of 16 patients with CMV retinitis treated between February 2014 and January 2017. The medical records were reviewed and demographics, clinical signs, treatment course and visual result analyzed.

twenty five eyes of 16 patients were included. Five patients (31.3%) were men and eleven patients (68.7%) were women. Mean follow up period was 7.31 months. The mean age of patients was 29.38 ± 17.12 years (Range 11 - 75). Involvement was unilateral in 7 cases (43.75 %) and bilateral in 9 cases (56.25%). HIV serology was negative in all patients. Acute lymphoblastic leukemia (ALL), chemotherapy in renal transplant recipients, ulcerative colitis, T-cell lymphoma, uncontrolled diabetes mellitus, sarcoidosis were the primary cause of immunosuppression in 6, 4, 1, 1, 2, 1 of the patients, respectively. Each patients treated by systemic and intravitreal antiviral agents. The mean number of intravitreal ganciclovir injections was 3.44 ± 1.03 (Range 2-6) injections per eye. Visual acuity (VA) after anti-CMV treatment was worse (logarithm of the minimal angle of resolution best-corrected VA on presentation, 0.57±0.55 [Snellen VA,20/74]; logarithm of the minimal angle of resolution best-corrected VA on final visit, 0.69±0.55 [Snellen VA,20/100]) (P=0.096). A four-month old infant affected by disseminated disease and bilateral CMV retinitis died despite systemic and intravitreal antiviral treatment. One patient developed rhegmatogenous retinal detachment and treated by pars plana vitrectomy, endolaser anad silicone oil tamponade. One other patient developed iris neovascularization and neovascular glaucoma.

CMV retinitis is a devastating complication in immunosuppressed patients. No HIV positive patient was seen during the study and the visual prognosis was poor despite appropriate antiviral treatment.