Table 8.
Demographics and clinical characteristics of cytomegalovirus retinitis
| Author (year) | Age (years) |
Gender | Laterality | Immunodeficiency | Method of diagnosis |
Symptoms | Signs | VA at presentation |
Treatment | Complications | Duration of follow- up (months) |
VA at last visit |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kuo et al (2004)140 | Mean: 50; Median: 58; range: 14–74 | M: 13; F: 5 | B: 12; U: 6 | Immunosuppressive drugs: 18 | NR | Blurred vision, floaters, scotoma | Necrotizing retinitis, intraretinal hemorrhage, with granular or edematous borders | >20/50: 11 (37%); >20/200: 5 (20%) | IV ganciclovir, ganciclovir implant, intraocular foscarnet, sub-Tenon corticosteroid | Involvement of second eye, RD, IRU, posterior subcapsular cataract, CME, ERM, optic atrophy | 12 | >20/50: 17 (58%); >20/200: 13 (45%) |
| Jabs et al (2004)108 | Mean: 41 | M: 224; F: 47 | B: 97; U: 174 | HIV+: 271; CD4+ <50: 34.0%; CD4+ 50–99: 12.7%; CD4+ 100–199: 17.5%; CD4+ ≥200: 35.8% | Clinical | NR | Necrotizing retinitis, atrophic and gliotic scar | NR | Ganciclovir implant: 42.2%; systemic ganciclovir: 17.5%; Intravitreal injection: 3.0%; HAART: 79.8% | Progression of retinitis, involvement of second eye, RD, IRU | NR | NR |
| Pathanapitoon et al (2013)189 | Mean: 49; range: 29–65 | M: 11; F: 7 | B: 4; U: 14 | Immunosuppressive drugs: 11; primary immunodeficiency: 1 | Aqueous PCR | NR | Focal hemorrhagic retinitis, granular retinitis, ARN, vitritis, retinal arteritis, frosted branch angiitis | NR | Systemic/intraocular ganciclovir, vitrectomy | ERM, RD, traction | Mean: 24; range: 3–60 | NR |
| Schneider et al (2013)214 | Mean: 71.0; median: 74; range: 48–83 | M: 4; F: 1 | B: 1; U: 4 | Immunosuppressive drugs: 2 | Aqueous/vitreous PCR, retinal biopsy | Progressive vision loss, floaters, scotoma | Slowly progressive granular retinitis, occlusive panretinal vasculitis, retinal hemorrhages, optic neuritis | OS: PL | IV ganciclovir, oral valganciclovir, intravitreal foscarnet, panretinal photocoagulation, vitrectomy | Retinal neovascularization, vitreous hemorrhage, RD, phthisis | Mean: 13.2; range: 7–21 | OS: HM |
| OD: HM | OD: HM | |||||||||||
| OS: 20/25 | OS: 20/20 | |||||||||||
| OD: 20/30 | OD: 20/30 | |||||||||||
| OS: 5/200 | OS: HM | |||||||||||
| Jabs et al (2013)106 | Median: 40.0; range: 34–45 | M: 196; F: 54 | B: 88; U: 162 | HIV+: 250; median | Clinical | NR | Full thickness necrotizing retinitis | Mean: 20/42 | HAART, oral valganciclovir, IV ganciclovir/cidofovir/foscarnet, intravitreal ganciclovir/foscarnet, ganciclovir implant | RD, IRU, visual field loss, second eye involvement | Mean: 60; range: 20.4–90 | >20/40: 27.8%; >20/200: 12.4% |
| CD4+ count: 20 | ||||||||||||
| Agarwal et al (2014)4 | Mean: 33.7 ± 15.7; range: 11–63 | M: 6; F: 4 | B: 8; U: 2 | Immunosuppressive drugs: 8 | Clinical, vitreous PCR | Blurred vision, floaters | Vascular sheathing, CMV lesions | Mean: 0.51 ± 0.41; range: 0–1.9 | Intravitreal ganciclovir | IRU, posterior subcapsular cataracts, RD, CME, ERM | Mean: 9.46 ± 12.42 | Mean: 0.43 ± 0.52; range: 0–1.9 |
| Huang et al (2015)100 | Mean: 38 ± 9; range: 18–60 | M: 58; F: 9 | B: 37; U: 30 | HIV+: 67; mean CD4+ count: 31.7 ± 33.9 | NR | Ocular discomfort, blurred vision, visual field defects, floaters | Perivascular yellowish white necrotic retinal infiltration with granular borders, intraretinal hemorrhages, retinal vasculitis, optic neuritis | <0.05: 23; 0.05–0.3: 31; >0.3: 44 | HAART, IV ganciclovir/foscarnet, oral/intravitreal ganciclovir | Macular necrosis, RD, cataracts, IRU | Range: 5–44 | No improvement: 26 (33.3%); improved: 39 (50.0%); <0.05: 28.9% |
| Summary; n, % | Mean: 47.1; range: 11–83 | M: 512 (80.1); F: 127 (19.9) | B: 247 (38.7); U: 392 (61.3) | HIV+: 588 (92.0); immunosuppressive drugs: 39 (6.1) | Clinical, aqueous/vitreous PCR | Blurred vision, floaters, scotoma, ocular discomfort | Necrotizing retinitis, retinal hemorrhage, vasculitis, optic neuritis | Range: 20/20-PL | HAART, systemic/intraocular valganciclovir, ganciclovir, cidofovir, foscarnet, vitrectomy, corticosteroid | Progression, second eye involvement, RD, IRU, CME, ERM, cataracts, phthisis, neovascularization, optic atrophy | Mean: 23.7; range: 3–90 | Majority no improvement |
ARN, acute retinal necrosis; B, bilateral; CMV, cytomegalovirus; CME, cystoid macular edema; EBV, Epstein-Barr virus; ERM, epiretinal membrane; F, female; HAART, highly active antiretroviral therapy; HM, hand movement; HSV, herpes simplex virus; IV, intravenous; IRU, immune recovery uveitis; M, male; NPL, no light perception; NR, not reported; OD, oculus dexter; OS, oculus sinister; PL, light perception; PORN, progressive outer retinal necrosis; RD, retinal detachment; RPE, retinal pigment epithelium; U, unilateral.