Optimal management of cytomegalovirus retinitis in patients with AIDS

Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Cytomegalovirus (CMV) retinitis is the most common cause of vision loss in patients with acquired immunodeficiency syndrome (AIDS). CMV retinitis afflicted 25% to 42% of AIDS patients in the pre-hig...

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Autor principal:	Michael W Stewart
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/aca0f25151e14100837bfcf8296c2a18
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spelling	oai:doaj.org-article:aca0f25151e14100837bfcf8296c2a182021-12-02T05:27:43ZOptimal management of cytomegalovirus retinitis in patients with AIDS1177-54671177-5483https://doaj.org/article/aca0f25151e14100837bfcf8296c2a182010-04-01T00:00:00Zhttp://www.dovepress.com/optimal-management-of-cytomegalovirus-retinitis-in-patients-with-aids-a4219https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Cytomegalovirus (CMV) retinitis is the most common cause of vision loss in patients with acquired immunodeficiency syndrome (AIDS). CMV retinitis afflicted 25% to 42% of AIDS patients in the pre-highly active antiretroviral therapy (HAART) era, with most vision loss due to macula-involving retinitis or retinal detachment. The introduction of HAART significantly decreased the incidence and severity of CMV retinitis. Optimal treatment of CMV retinitis requires a thorough evaluation of the patient&rsquo;s immune status and an accurate classification of the retinal lesions. When retinitis is diagnosed, HAART therapy should be started or improved, and anti-CMV therapy with oral valganciclovir, intravenous ganciclovir, foscarnet, or cidofovir should be administered. Selected patients, especially those with zone 1 retinitis, may receive intravitreal drug injections or surgical implantation of a sustained-release ganciclovir reservoir. Effective anti-CMV therapy coupled with HAART significantly decreases the incidence of vision loss and improves patient survival. Immune recovery uveitis and retinal detachments are important causes of moderate to severe loss of vision. Compared with the early years of the AIDS epidemic, the treatment emphasis in the post-HAART era has changed from short-term control of retinitis to long-term preservation of vision. Developing countries face shortages of health care professionals and inadequate supplies of anti-CMV and anti-HIV medications. Intravitreal ganciclovir injections may be the most cost effective strategy to treat CMV retinitis in these areas.Keywords: cytomegalovirus, AIDS, retinitis, immune recovery uveitis, retinal detachment, treatment Michael W StewartDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 285-299 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Michael W Stewart Optimal management of cytomegalovirus retinitis in patients with AIDS
description	Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Cytomegalovirus (CMV) retinitis is the most common cause of vision loss in patients with acquired immunodeficiency syndrome (AIDS). CMV retinitis afflicted 25% to 42% of AIDS patients in the pre-highly active antiretroviral therapy (HAART) era, with most vision loss due to macula-involving retinitis or retinal detachment. The introduction of HAART significantly decreased the incidence and severity of CMV retinitis. Optimal treatment of CMV retinitis requires a thorough evaluation of the patient&rsquo;s immune status and an accurate classification of the retinal lesions. When retinitis is diagnosed, HAART therapy should be started or improved, and anti-CMV therapy with oral valganciclovir, intravenous ganciclovir, foscarnet, or cidofovir should be administered. Selected patients, especially those with zone 1 retinitis, may receive intravitreal drug injections or surgical implantation of a sustained-release ganciclovir reservoir. Effective anti-CMV therapy coupled with HAART significantly decreases the incidence of vision loss and improves patient survival. Immune recovery uveitis and retinal detachments are important causes of moderate to severe loss of vision. Compared with the early years of the AIDS epidemic, the treatment emphasis in the post-HAART era has changed from short-term control of retinitis to long-term preservation of vision. Developing countries face shortages of health care professionals and inadequate supplies of anti-CMV and anti-HIV medications. Intravitreal ganciclovir injections may be the most cost effective strategy to treat CMV retinitis in these areas.Keywords: cytomegalovirus, AIDS, retinitis, immune recovery uveitis, retinal detachment, treatment
format	article
author	Michael W Stewart
author_facet	Michael W Stewart
author_sort	Michael W Stewart
title	Optimal management of cytomegalovirus retinitis in patients with AIDS
title_short	Optimal management of cytomegalovirus retinitis in patients with AIDS
title_full	Optimal management of cytomegalovirus retinitis in patients with AIDS
title_fullStr	Optimal management of cytomegalovirus retinitis in patients with AIDS
title_full_unstemmed	Optimal management of cytomegalovirus retinitis in patients with AIDS
title_sort	optimal management of cytomegalovirus retinitis in patients with aids
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/aca0f25151e14100837bfcf8296c2a18
work_keys_str_mv	AT michaelwstewart optimalmanagementofcytomegalovirusretinitisinpatientswithaids
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Optimal management of cytomegalovirus retinitis in patients with AIDS

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