CMV, similar to HIV, is capable of causing a latent infection that often reactivates in immunocompromised individuals. Nearly all of HIV-positive homosexual males have CMV antibodies and more than half shed virus in the urine or semen. CMV retinitis in the pre-AIDS era was a rare complication of leukemia, lymphoma, and iatrogenic immunosuppression following organ transplantation. The AIDS epidemic has dramatically increased the prevalence of CMV retinitis. Symptoms of CMV retinitis may include floaters or painless loss of central or peripheral vision.
Most patients are asymptomatic unless the optic nerve or macula are involved.
Although the eyes will always look and feel normal, a thorough dilated retinal examination is needed to diagnose the retinal infection. Diagnosis is based on the clinical findings of hemorrhagic retinal inflammation often following a vascular distribution. If left untreated, the infection will spread throughout the retina and cause blindness. Retinal detachment is a late cause of vision loss, and may develop in eyes with completely inactive infection. Vitrectomy surgery is often able to reattach the retina with preservation of vision.