RT Book, Section
A1 Effron, David
A1 Forcier, Beverly C.
A1 Wyszynski, Richard E.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181039674
T1 Cytomegalovirus Retinitis
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181039674
RD 2023/09/24
AB Patients  may  complain  of  the  gradual  and  usually  painless  onset  of  the  following  visual  sensations:  floaters,  scintillating  scotomas  (quivering  blind  spots),  decreased  peripheral  visual  field,  and  metamorphopsia  (wavy  distortion  of  vision).  Cytomegalovirus  (CMV)  infiltrates  appear  as  focal,  small  (but  may  be  larger,  confluent)  white  lesions  in  the  retina  that  look  like  cotton  wool  spots.  CMV  is  a  necrotizing  virus  that  is  spread  hematogenously,  so  that  damage  is  concentrated  in  the  retina  adjacent  to  the  major  vessels  and  the  optic  disk.  Often  hemorrhage  is  involved  with  significant  retinal  necrosis  (dirty  white  with  a  granular  appearance),  giving  the  “pizza  pie”  or  “cheese  and  ketchup”  appearance.  Optic  nerve  involvement  and  retinal  detachments  can  be  present.