First Author: A.B.Gonzalez Escobar SPAIN
Co Author(s): A. Chinchurreta Capote M. Lorenzo Soto S. Gismero Moreno R. Kamal Salah 0 0 0 0 0 0 0 0 0
Emphasize the importance (in AIDS patients at high risk for developing CMV retinitis) of early diagnosis for good progress of the disease, and the importance of prophylaxis in patients with CD4 + cell counts below 50 cells / uL
CMV chorioretinitis patient, ganciclovir treated, with good visual acuity result, after early diagnosis and treatment.
35 years old male, recently diagnosed with AIDS CD4+ lymphocytes count of 12 cells/mm3, receives antiretroviral treatment and prophylaxis with trimethoprim sulfamethoxazole. (Not received ganciclovir although it is indicated, because of low lymphocyte count). Both eyes floaters. Physical examination revealed a visual acuity of 0.6 in the right eye and 0.8 in left eye and two bleeding whitish foci associated with satellite lesions compatible with cytomegalovirus chorioretinitis, in the right eye four disc diameters size above macula, and a nasal focus, and in the left eye, a focus below the papilla.
The patient had widespread CMV dissemination, and was treated with intravenous ganciclovir 5mg/kg every 12 hours 3 weeks induction phase, and subsequently oral valganciclovir 900 mg every 24 hours as maintenance phase. Since so close to the disc an macula, intravitreal induction treatment is started, of two weekly injections of ganciclovir 0.5 mg / 0.05 ml for two weeks, moving to a weekly injection until the resolution of retinitis. Eleven intravitreal injections in the right eye and 7 in the left eye were needed, atrophic scar remaining in first, and no signs in the second eye, visual acuity unit in both eyes.
CMV is the most common intraocular infection in AIDS and the first cause of blindness. High-risk patients (HIV