A HIV patient complains of visual disturbances. Fundal examination shows bilateral retinal exudates and perivascular haemorrhages. Which of the following viruses are most likely to be responsible for this retinitis –
Correct Answer: Cytomegalovirus
Description: CMV retinitis is the most common ocular infection in AIDS patient.
CMV retinitis
Presentation :
Presents as a painless progressive loss of vision.
Patients may also complain of 'blurred vision', Floaters and scintillations.
Opthalmoscopic findings : (Bilateral)
Characteristic retinal appearance ofperivascular haemorrhages and retinal exudates - Harrison
Cotton wool spots appearing as a result of focal ischaemia of nerve fibre layer are characteristic
Risk factors :
The majority of cases of CMV retinitis occur in patients with CD4+ count < 50/ 1.
Patients with CD4+ count < 100 / 1 should undergo an ophthalmic examination every 3-6 months.
Treatment:
Therapy for CMV retinitis consists of intravenous ganciclovir
Forscarnet (cidofovir is an alternative).
Category:
Medicine
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