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Cytomegalovirus Retinitis in the Post-cART Era

  • Ocular Microbiology and Immunology (B Jeng and L Schocket, Section Editors)
  • Published:
Current Ophthalmology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the epidemiology, diagnosis, and management of cytomegalovirus retinitis (CMVR) in the post-combined antiretroviral era (cART) era.

Recent Findings

Although cART has dramatically reduced CMVR incidence and morbidity in the HIV population, CMVR continues to cause significant vision loss in both HIV and non-HIV patients, especially among patients without immune reconstitution. Advances in imaging including ultra-widefield fundus and autofluorescence imaging, optical coherence tomography, and adaptive optics may reflect CMVR activity; however, the diagnosis remains a clinical one. There have been minimal advances in therapy, with several agents no longer available due to market concerns.

Summary

Despite reduced incidence and morbidity in the post-cART HIV population, CMVR continues to cause vision loss among HIV and non-HIV patients. Diagnosis remains primarily clinical, and therapy centers upon immune reconstitution along with systemic and/or intravitreal antivirals. Further studies are necessary to determine whether advanced imaging can influence management, and whether novel antiviral agents or adoptive immune transfer have a role in treatment of drug-resistant CMVR.

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  1. Department of Ophthalmology, Weill Cornell Medicine, 1305 York Avenue, 11th Floor, New York, NY, 10021, USA

    Alexander D. Port, Rolake O. Alabi, Lisa Koenig & Mrinali P. Gupta

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  1. Alexander D. Port
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  2. Rolake O. Alabi
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Correspondence to Mrinali P. Gupta.

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Rolake O. Alabi was supported by a Medical Scientist Training Program grant from the NIH: T32GM007739 grant to the Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Alexander D. Port, Lisa Koenig, and Mrinali P. Gupta declare that they have no conflict of interest.

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ADP, ROA, LK, MPG: none.

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This article is part of the Topical Collection on Ocular Microbiology and Immunology

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Port, A.D., Alabi, R.O., Koenig, L. et al. Cytomegalovirus Retinitis in the Post-cART Era. Curr Ophthalmol Rep 6, 133–144 (2018). https://doi.org/10.1007/s40135-018-0173-4

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