Cytomegalovirus retinitis in the absence of AIDS

Objective: The purpose of this study was to evaluate systemic and ophthalmic features associated with Cytomegalovirus (CMV) retinitis in immunocompetent patients. Design: Retrospective chart review. Participants: Nine patients with CMV retinitis who were clinically immunocompetent at the time of diagnosis. Methods: Retrospective chart review of patients evaluated at the Casey Eye Institute, University of Washington, Bascom Palmer Eye Institute and University of Toronto. IRB approval was obtained. Retrospective chart review of patients evaluated at the Casey Eye Institute, University of Washington, Bascom Palmer Eye Institute and University of Toronto. IRB approval was obtained. Results: Seven of the nine patients in our series were 60 years of age or above. Three patients had intravitreal steroid and VEGF inhibitor injections in the preceding year in the affected eye. Five of the nine patients were initially misdiagnosed to have acute retinal necrosis (ARN) for which they were on Valacyclovir for a variable period of time. Seven patients had anterior chamber and eight had vitreous inflammation. Six of the nine patients exhibited vascular attenuation or obliteration. All patients showed improvement in retinitis within weeks following therapy with intravitreal foscarnet and/or ganciclovir and systemic valganciclovir.