Presents with visual changes, decreased vision, floaters, flashes of light, blind spots, and blurred vision. Diagnosed by funduscopic exam. Fluffy white infiltrates associated with central pallor, surrounding retinal hemorrhage, and perivascular sheathing are seen. Can cause retinal hemorrhage. Must add IgG to therapy.
Median survival is longer with foscarnet.
However, both ganciclovir and foscarnet are fairly toxic. Must continue lifelong suppression for CMV retinitis. Studies are currently being done to determine if combination treatment is cost effective. Side effects may be lessened with intravitreal injections. Other drugs under investigation.