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Macular CMV retinitis: a case report
P Demols1, C A Claes, C M Farber
1Department of Ophthalmology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. pdemols@tiscali.be
Purpose:
Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection associated with AIDS. It usually affects the peripheral retina, sparing the macula. We describe an atypical CMV retinitis exclusively confined to the macula.
Methods:
A 43-year-old man with the diagnosis of AIDS developed a white retinal lesion confined to the macula of the right eye. Two weeks later, a more typical granular appearance was observed leading to presumption of CMV retinitis.
Results:
The patient was treated with ganciclovir without success. With foscarnet, a good response was obtained, leading to total healing of the lesion.
Conclusions:
CMV retinitis has to be taken into consideration in all lesions confined to the macula in immunodepressed patients. An early diagnosis is crucial to avoid blindness.
Insights
A rare case of Cytomegalovirus (CMV) retinitis affecting only the macula in an AIDS patient was successfully treated with foscarnet. Early diagnosis of this atypical CMV retinitis is crucial for preventing vision loss.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Retinal Imaging
Background:
- Cytomegalovirus (CMV) retinitis is a common opportunistic infection in AIDS patients.
- Typically, CMV retinitis affects the peripheral retina, sparing the macula.
Observation:
- A 43-year-old male with AIDS presented with a unique white retinal lesion exclusively in the macula.
- The lesion evolved to a granular appearance, suggestive of CMV retinitis.
Findings:
- Initial treatment with ganciclovir was unsuccessful.
- Foscarnet therapy resulted in a positive response and complete healing of the macular lesion.
Implications:
- CMV retinitis should be considered in immunocompromised patients with macular lesions.
- Prompt diagnosis and appropriate antiviral therapy are essential to prevent blindness from atypical CMV retinitis.
