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SM Wren, D Bethell, AR Fielder, EG H Lyall, G Tudor-Williams, KD Cocker, SM Mitchell; Features of Cytomegalovirus Retinitis in infancy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2212.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To study retinal involvement in cytomegalovirus (CMV) infection in a series of immunocompromised infants under one year of age. Methods:Infants presenting to a paediatric infectious diseases unit with CMV retinitis were studied. The CMV infection was either associated with HIV infection or prematurity; proven using molecular methods based on the polymerase chain reaction (PCR.). During the same period, other infants with HIV infection and AIDS defining illnesses, without retinal changes were compared to those with retinitis. Contact digital photography was used to monitor the retinal changes. Results: Retinal abnormalities were detected in 5 of the children screened (age 0-10 months). Vitreous samples were taken in 3 cases and qualitative PCR based assays confirmed the presence of CMV DNA. Comparisons between the HIV infected infants with and without retinal changes demonstrated a significant difference (p<0.05 Mann-Whitney test) for CMV viral load. The retinal features included superficial white flecks at the macula, (which did not progress over 3 months) in 4 infants, with also disturbance to retinal pigment epithelial disturbance in 1 infant, and a more classical CMV retinitis in a10 month old infant. Conclusion:In this case series of 5 infants, CMV retinitis was located in a predominantly at the macula unlike the typical presenting pattern seen in adults. Additionally, the clinical course was stable and non-progressive in two infants, while three followed a more aggressive course requiring intravitreal therapy. Comparing blood results of the immunocompromised children, the presenting viral loads of infants with retinal changes, were significantly greater.
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