This 29YO male presented to us 6 years earlier with bilateral cytomegalovirus (CMV) retinal detachments. At that time, he was severely ill from untreated HIV/AIDS.
He underwent bilateral vitrectomy surgery with silicone oil. Since then, he has done extremely well systemically, with normal CD4 counts and undetectable viral loads.
Despite severe bilateral chorioretinal scarring and a partial peripheral detachment under oil OD, vision is 20/400 bilaterally, and he is functioning well.
We have no plans to remove the oil, as his retinal appearances have remained stable since surgery.
Learning Points:
Cytomegalovirus (CMV) retinitis develops as a reactivation of latent CMV in immunosuppressed individuals. Before effective antiretroviral treatment emerged in the mid to late 1990’s (highly active antiretroviral therapy, HAART), CMV retinitis developed in up to 40% of HIV/AIDS patients, often within the last 6 months of life.
Treatment includes a combination of intravenous and intravitreal medications, including ganciclovir, foscarnet, and cidofovir.
Rhegmatogenous retinal detachment is a common late sequela of CMV infection and may require vitrectomy for repair.
