Diagnosis of CMV infection is usually based upon fundus findings. In addition, throat or urine cultures may be sent. The vast majority of CMV retinitis cases are AIDS-related, with CMV being the most common ocular infection in these patients. Infections may be unilateral or bilateral. Most unilateral cases progress to involve the other eye, presumably vial hematogenous spread.
Spontaneous regression is extremely rare.
With involvement limited to the periphery, patients may have no subjective complaints, or may complain of floaters. If the involvement begins in the posterior pole, the patient may notice a visual field defect. It is difficult to repair using the standard techniques because of the markedly atrophic nature of the previously infected retinal material. However, most cases can be repaired successfully using silicon oil as a tamponade. Toxoplasmosis retinitis appears quite different.