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Opportunistic infection: Cytomegalovirus retinitis

Cytomegalovirus is a member of the herpes virus family and almost all adults are silently infected with this virus during childhood when infection with this virus does not cause any symptoms.

Cytomegalovirus is reactivated in the very late stages of AIDS and can attack a number of organs. The eye is vulnerable to cytomegalovirus, specifically the retina, the layer of special light-detecting cells at the back of the eye.

Symptoms and diagnosis
Cytomegalovirus retinitis causes failing vision in one or both eyes. The condition is painless. If untreated it will eventually cause blindness. It can be diagnosed by examination of the retina using a hand-held opthalmoscope. The doctor will see tell-tale haemorrhages (bleeding) and exudates (fluffy spots) on the retina.

Treatment
Cytomegalovirus infections can be treated with a drug called ganciclovir. The drug can be given intravenously or orally, but in the case of retinitis it is best given as a slow-release implant placed directly in the eye under local anaesthetic. Treatment for cytomegalovirus retinitis must usually be lifelong or the disease will relapse.

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