This patient presented in 1994 with classic active cytomegalovirus (CMV) retinitis, which appeared as a “cottage cheese and ketchup” hemorrhagic retinitis following a vascular distribution. The retinitis spreads outwards, leaving behind thinned, necrotic retina and retinal pigment epithelium.
Learning Points:
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 anti-viral medications, including ganciclovir, foscarnet, and cidofovir. There is a high incidence of retinal detachment, especially with larger areas of involved retina.
