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Published on: July 6, 2013
Comparative Clinical Features, Vascular Complications, and Outcomes in CMV Retinitis: Pediatric vs HIV Positive and
Figen Bezci Aygun1, Celal Ulutaş2, Sibel Kadayıfcılar1
1Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Purpose:
To compare the clinical features, complications, and outcomes of cytomegalovirus retinitis (CMVR) among pediatric patients, HIV positive adults, and HIV negative immunocompromised adults.
Methods:
This retrospective observational study included 41 patients (66 eyes) diagnosed with CMVR between 2000 and 2024. Patients were categorized as pediatric (all HIV negative), HIV positive adults, and HIV negative adults. Clinical characteristics, lesion morphology and extent, vascular involvement, recurrence, structural complications, immune recovery uveitis (IRU), and visual outcomes were evaluated. Retinal involvement was graded by estimated percentage of total retinal area affected. Statistical analyses were performed at both patient and eye levels, with additional analyses accounting for inter-eye correlation.
Results:
Fourteen patients were pediatric, 13 were HIV positive adults, and 14 were HIV negative adults. Pediatric patients more frequently demonstrated bilateral involvement, extensive retinal disease, central involvement, and higher rates of retinal detachment. HIV negative adults showed higher rates of vascular involvement and recurrence, whereas HIV positive adults exhibited milder inflammatory features but remained at risk for retinal detachment and IRU. Fulminant-type lesions were associated with more extensive retinal involvement and structural complications. Visual outcomes varied according to lesion morphology and extent.
Conclusions:
CMVR demonstrates age and etiology related variability in clinical presentation and disease course. Pediatric patients, particularly following hematopoietic stem cell transplantation, may exhibit more severe manifestations, highlighting the importance of careful, age-informed retinal surveillance.
