Cytomegalovirus retinitis

Abstract

Ocular manifestations with cytomegalovirus (CMV),<i>Toxoplasma, Candida albicans, Cryptococcus</i>, herpes simplex virus, varicella zoster virus,<i>Mycobacterium avium-intracellulare</i>, and<i>Mycobacterium tuberculosis</i>have been reported in association with acquired immunodeficiency syndrome (AIDS).¹CMV retinitis is by far the most common cause of vision loss in these patients.¹ CMV retinitis has a very characteristic clinical appearance that consists of white granular lesions with without associated retinal hemorrhages (Fig 1). Lesions with hemorrhage have been described as resembling a "pizza pie." Retinal lesions without hemorrhage appear as white granular infiltrates that at times may be difficult to distinguish from cotton-wool spots. Cotton-wool spots, which are focal areas of infarction of the nerve fiber layers, are the most common ophthalmic manifestation of AIDS.¹Infarcts of the nerve fiber layer are also commonly seen in association with diabetes and hypertension. Unlike lesions in CMV retinitis, which progressively enlarge, cotton-wool spots in AIDS patients