The use of murine CMV (MCMV) to study ocular pathogenesis has been validated since the early 1980s in both C57BL6 and BALB/c mice. Īlthough CMVR in humans has been extensively studied through clinical studies, the lack of an animal model due to the species specificity of CMV hindered in vivo research especially those that mimic HIV induced CMVR, for a long period of time.
It has also been observed that CMV infection can occur during organ transplantation of bone marrow, heart, and lung. Possible transmission paths include prenatal intrauterine infection, perinatal infection through breast milk or genital secretions, and postnatal exchange of bodily fluids such as blood, saliva, and sperm. CMV infection may occur via multiple routes. There is an estimated global CMV seroprevalence of 83% in the general population. In this narrative review, the pathogenesis, ocular manifestations, treatment and complications of CMVR in HIV and non-HIV infected individuals are presented. CMVR may also be seen in other conditions associated with immunosuppression, including solid organ transplants, hematologic malignancy, and drug-induced immunosuppression. In the absence of known immune suppression, ocular manifestations of CMVR should raise suspicion for human immunodeficiency virus (HIV) infection and is classified as an acquired immunodeficiency syndrome (AIDS) defining illness.
CMVR can result in profound vision loss and may lead to retinal detachment and permanent vision loss.
#NORMAL RETINA VS CMV RETINITIS FULL#
CMVR is characterized by full thickness retinal inflammation, hemorrhage, and necrosis. One of the most deleterious manifestations of CMV infection in the eye is CMV retinitis (CMVR). CMV presents as an opportunistic infection in 75–85% of cases and although infection can occur in healthy individuals, it is uncommon to observe symptomatic CMV infection in individuals who are not immune suppressed. The patient has remained inflammation-free for more than 20 months after vitrectomy, single ganciclovir injection, and 2 months of oral valganciclovir medication.Cytomegalovirus (CMV) is a member of the Herpesviridae family. Polymerase chain reaction of vitreous fluid confirmed the diagnosis of CMV retinitis. Viral retinitis was suspected, and the patient underwent diagnostic vitrectomy adjunctive with intravitreal ganciclovir injection. Two months later, perivascular retinal infiltration developed and vitritis recurred. Medication was stopped, and an intravitreal dexamethasone implant was fitted to address worsening inflammation. However, the patient complained of systemic side effects from the oral steroids. Uveitis was much improved after the patient started taking oral steroid medication. After laboratory examinations, the patient was diagnosed with non-infectious panuveitis. Fundus examination and fluorescein angiography showed dense vitritis, but no definite retinal infiltration. A 60-year-old woman was referred to our hospital for recurrent anterior uveitis.
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