| Presentation preference | Oral presentation |
| Title | Immune dysfunction in CMV retinitis |
| Purpose | Cytomegalovirus (CMV) retinitis (CMVR) is often related to human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). Nowadays, it is also increasingly associated with immunosuppression from chemotherapy and autoimmune diseases. Our purpose is to present a case series of CMVR in both HIV and non-HIV patients with CMVR, describe and compare its characteristics, diagnosis and treatment. |
| Methods | Retrospective observational case-series. |
| Results | Medical records of 6 patients were collected. All cases fulfilled the classification criteria for CMVR. In 3 of them CMVR was associated to HIV/AIDS, while the remaining 3 patients were immunocompromised due to chemotherapy or immunosuppressive medication. Half of the patients presented with bilateral disease and unilateral cases corresponded to the 3 HIV-infected patients. Fundoscopy revealed a granular type of CMVR in 3 patients, while the other 3 exhibited a hemorrhagic appearance. In 2 of these cases vitreous hemorrhage was the first clinical manifestation, but the main presenting symptom was diminished visual acuity. Concomitant retinal vasculitis was present in half of the cases and anterior uveitis was present in 4 patients. Immune-recovery uveitis (IRU) occurred in half of the cases. Aqueous or vitreous tap and polymerase chain reaction (PCR) analysis was done in 4 cases, confirming the diagnosis of CMVR. |
| Conclusion | Clinicians should be alert to the possibility of CMVR in non-HIV patients. Aqueous tap is a useful aid in the diagnosis of viral retinitis. Treatment can be challenging, not only of the CMV but also its complications such as IRU, an entity that is expected to increase in the future due to longer life expectancy in these patients. |
| Conflict of interest | No |
Authors 1
| Last name | PINTO PROENÇA |
| Initials of first name(s) | R |
| Department | Ophthalmology, Hospital de Cascais, Dr. José de Almeida |
| City | Lisboa |
| Country | Portugal |
Authors 2
| Last name | MOTA |
| Initials of first name(s) | C |
| Department | Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central |
| City | Lisboa |
| Country | Portugal |
Authors 3
| Last name | Barão |
| Initials of first name(s) | C |
| Department | Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central |
| City | Lisboa |
| Country | Portugal |
Authors 4
| Last name | Pinto-Ferreira |
| Initials of first name(s) | F |
| Department | Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central |
| City | Lisboa |
| Country | Portugal |
Authors 5
| Last name | Anjos |
| Initials of first name(s) | R |
| Department | Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central |
| City | Lisboa |
| Country | Portugal |
Authors 6
| Last name | SILVA |
| Initials of first name(s) | P |
| Department | Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central |
| City | Lisboa |
| Country | Portugal |
