How to Manage Cytomegalovirus Retinitis?
Eye Health Data Verified

Cytomegalovirus Retinitis - Causes, Symptoms, Diagnosis, and Management

Published on Oct 06, 2022 and last reviewed on Mar 07, 2023   -  4 min read


It is an opportunistic infection of acquired immunodeficiency syndrome (AIDS) affecting the retina of the eyes. Read this article below to learn more about it.


As we all know, AIDS is a life-threatening condition caused by the dreadful human immunodeficiency virus (HIV). HIV infection is usually spread by sexual contact or contact with the infected saliva, body fluids, sharing razors, etc. It is considered life-threatening because it affects an individual's immune system and gives way to opportunistic infections. Cytomegalovirus retinitis is one such opportunistic infection of HIV infection. Many other immune weakening disorders can also cause it. However, the retinal layer of the eye is primarily affected. Cytomegalovirus is a type of herpes virus. In people with weak immune systems, like in an individual with HIV infection, the retinal layer of the eye gets infected by cytomegalovirus. As a result, the retina becomes necrosed, which results in detachment and tears. Cytomegalovirus retinitis infection is common among males and females aged 20 and 50.

Cytomegalovirus can get transmitted in various ways:

  • From infected mother to child through the placenta. If the child escapes placental transmission, the child may acquire the virus from vaginal secretions during vaginal delivery.

  • Through organ transplantations and blood transfusions.

  • Through saliva by sharing food and drinks.

  • In adult groups, sexual intercourse is the main mode of transmission.

  • Transmission through the fecal-oral route is also possible, and cases are recorded.

What Are the Symptoms of Cytomegalovirus Retinitis?

CMV retinitis infection will show signs in one eye initially and then starts in the other eye. The most common signs and symptoms of cytomegalovirus retinitis are as follows.

What Are the Causes of Cytomegalovirus Retinitis?

Cytomegalovirus retinitis is caused by cytomegalovirus, a type of herpes virus. Most human beings will come in contact with cytomegalovirus at least once in their lifetime. But only the ones with the weaker immune system will get infected severely and show signs and symptoms.

Conditions that weaken the immune system and give way to CMV infections like CMV retinitis are,

  • Human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS).

  • Bone marrow transplant patients will have a weaker immune system till three to twelve months after the procedure.

  • Cancer patients undergoing chemotherapy will generally have a weak immune system.

  • Even organ transplant patients will have a weak immune system.

  • Certain drugs like Prednisone, Dexamethasone, Dapsone, Methotrexate, Sulfasalazine, and Hydroxychloroquine can suppress the immune system.

  • Aplastic anemia.

HIV/AIDS is the most common cause of cytomegalovirus infection.

Who Is at Risk of Acquiring Cytomegalovirus Retinitis?

Those people with a weaker immune system are at higher risk for acquiring cytomegalovirus retinitis. People having the following conditions are more likely to develop CMV retinitis.

  • Human immunodeficiency virus (HIV) infection and acquired immunodeficiency virus syndrome (AIDS).

  • People undergoing chemotherapy to treat cancer or leukemia.

  • People undergoing organ transplants or specifically bone marrow transplants.

What Are the Possible Differential Diagnosis of Cytomegalovirus Retinitis?

Some of the conditions that can be misunderstood in place of CMV retinitis are,

  • HIV retinopathy - It is characterized by internal bleeding and a cotton wool appearance. Thus, it is often mistaken place of CMV retinitis. HIV retinopathy is more common in occurrence than CMV retinitis.

  • Syphilis.

  • Herpes zoster infection.

  • Toxoplasmosis.

  • Tuberculosis (TB).

  • Behcet disease.

  • Bacterial endophthalmitis.

  • Intraocular lymphoma.

What Are the Complications Associated With Cytomegalovirus Retinitis?

If CMV retinitis is left untreated, it may progress to cause,

  • Retinal detachment.

  • Necrosis of the retina.

  • Damages to the optic nerve.

  • Blindness - Permanent or temporary.

What Are the Three Stages of Retinitis?

A retinitis condition shows three patterns in general, and they are:

  • Hemorrhagic - Behind the necrotic retinal layer, large spots of hemorrhage can be seen.

  • Brush Fire - It is characterized by yellow-white lines seen in the margins of a necrotizing retina.

  • Granular - There will be hemorrhage spots present. Instead, white granular lesions can be seen along with the infected retinal layer of the eye.

How to Diagnose Cytomegalovirus Retinitis?

Diagnosis of CMV retinitis will include physical examination, lab tests, and imaging tests. The physical examination will include proper pupil dilation to study the retina clearly and find hemorrhagic spots, retinal detachments, etc. Imaging studies will include ultrasonography to study the severity of retinal detachment and fundus photography to assess the retinitis condition in general. Lab tests will include a polymerase chain reaction to detect the presence of cytomegalovirus.

How to Manage Cytomegalovirus Retinitis?

Managing the HIV infection (if it is the cause) is mandatory as a further decrease in the CD4 plus cells may cause CMV retinitis again and again. Before the advent of antiretroviral therapy, managing CMV retinitis was a task. But now, with appropriate treatment, it can be managed to a greater extent.

Antiretroviral drugs like Cidofovir, Foscarnet, and Valganciclovir can help manage the condition. These medicines can be taken as an oral pill, injection into the vein and eyes, or as an eye implant, giving out medicines at a particular pace. However, taking medications for a long time can make CMV resistant to drugs. Thus, the condition must be treated immediately without any delay.

How to Prevent CMV Retinitis?

The only way to prevent cytomegalovirus retinitis is by taking appropriate antiretroviral drugs in case of HIV infection. However, the condition may become severe if proper treatment is not undergone and give way to opportunistic infections like CMV retinitis.


CMV retinitis has immense potential to cause blindness that can be reversed with any treatment or medications. Thus, prevention is the only cure. However, taking appropriate measures to develop HIV infection or any immunosuppressive condition will help.

Frequently Asked Questions


How Is CMV Retinitis Caused?

Cytomegalovirus retinitis is caused by cytomegalovirus. It belongs to the herpes virus family. It is believed that human immunodeficiency virus or acquired immunodeficiency syndrome is the major cause of CMV retinitis. HIV infection will weaken the immune system of the affected individual and give way to various opportunistic infections. Cytomegalovirus retinitis is one of the opportunistic infections.


How Does Cytomegalovirus Affect the Eyes?

Cytomegalovirus retinitis is an opportunistic infection of HIV infection or AIDS. It is characterized by damage to the retinal layer of the eye, where it causes necrosis and results in retinal tears or retinal detachment. This infection can cause permanent blindness.


What Is the Treatment for CMV Retinitis?

CMV retinitis was a bit difficult to treat when there were no medications found. Now that antiretroviral drugs are used popularly, CMV retinitis can be brought under control. It can be managed from becoming worse. A few of the drugs used in the treatment are Cidofovir, Foscarnet, and Valganciclovir.


Does CMV Retinitis Cause Pain?

CMV retinitis usually starts in one eye and spreads to the other eye. It does not usually cause any pain. A few of the signs and symptoms of CMV retinitis are the presence of floaters and specks in the vision field, peripheral loss of vision, and vision loss.


What Is the Life Expectancy of Someone With CMV?

CMV is an infection that can be acquired right during birth or during the later stages of life. Cytomegalovirus retinitis is a serious condition and can be fatal in numerous cases. But with appropriate treatment, the condition can be controlled but not cured completely.


What Happens if Cytomegalovirus IgG Is High?

High levels of cytomegalovirus IgG suggest a connective tissue-related autoimmune disease such as rheumatoid arthritis or lupus erythematosus. These levels can be high even during pregnancy, and that indicates an infection in the fetus.


When Should CMV Viremia Be Treated?

If an individual is diagnosed with CMV viremia, the treatment with Ganciclovir should be started immediately. It should be continued for three weeks post, which has to be continued for seven days until the patient tests negative for CMV viremia.

Last reviewed at:
07 Mar 2023  -  4 min read




Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Is it good to have high IgG levels in the TORCH test while planning for pregnancy?

Query: Hi doctor, My wife was pregnant last year, but we had to drop. After dropping pregnancy, we consulted our gynecologist and he suggested us to have TORCH test. The result of TORCH before eight months was rubella IgG 40.62 and IgM 0.62, CMV IgG 8.89 and IgM 0.28 and herpes IgG 2.97 and IgM 0.56. We ha...  Read Full »

Viral Pharyngitis - Causes, Symptoms, Diagnosis and Treatment

Article Overview: Pharyngitis is an inflammation of the throat (pharynx). Read the article below to know more about how to combat the infection. Read Article

Shyam Kalyan. N
Shyam Kalyan. N
Otolaryngology (E.N.T)

Introduction: Pharyngitis is an upper respiratory tract infection that causes inflammation of the mucous membrane of the oropharynx (middle part of the throat behind the oral cavity). It is otherwise called cobblestone throat or sore throat. It usually causes pain, scratchiness in the throat, and di...  Read Article

Cytomegalovirus From Cats and Other Pets

Article Overview: Cytomegalovirus are organisms causing diseases in animals that may lead to malformations in the human body. This article is an overview of cytomegalovirus from pets. Read Article

Pandian. P
Pandian. P
General Surgery

What Is a Cytomegalovirus Infection? Cytomegaloviruses are microscopic organisms and agents of infection in a diversity of animals. The cytomegalovirus in humans has been associated with several infections that are known for leading to malformations. There are other kinds of cytomegalovirus infectio...  Read Article

Popular Articles Most Popular Articles

Do you have a question on Cytomegalovirus or Cytomegalovirus Retinitis?

Ask a Doctor Online

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.