Clinical profile and immunological status of cytomegalovirus retinitis in organ transplant recipients.
OBJECTIVE
Cytomegalovirus retinitis (CMV) is the most common ocular opportunistic infection in transplant recipients. This retrospective study attempts to report the differences in occurrence of cytomegalovirus retinetis in transplant recipients from those reported in patients with acquired immunodeficiency syndrome (AIDS).


METHODS
25 eyes of 15 transplant recipients (14 renal and one cardiac) with cytomegalovirus retinitis were retrospectively reviewed. Immunological profile included CD4+ and CD8+ T lymphocyte counts, CD4+/CD8+ cell ratio (5 cases) and serology for the viral antibodies (8 cases).


RESULTS
A predominantly bilateral presentation (60%) was noted. Active cytomegalovirus retinitis (72%) in zone 2 (92%) of the inferotemporal quadrant (68%) was noted. The average cell counts were within normal limits (mean CD4 cell count-711/microliter), unlike in late stages of AIDS with cytomegalovirus retinitis (CD4 count < 50/microliter). Serology revealed an IgM positivity of 53%. Retinal detachment (52%) was the most common complication occurring after an average of 5.4 months.


CONCLUSIONS
CMV retinitis in organ transplant recipients appears to differ from that in AIDS patients. CMV retinitis presents early and has different immunological profile, probably owing to differences in pathogenesis.
Medical and Vision Research Foundations, Sankara Nethralaya, 18, College Road, Chennai-600 006, India.
Ajeet M
AM
Wagle
Jyotirmay
J
Biswas
Lingam
L
Gopal
Hajib N
HN
Madhavan
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000276:immunology* / Q000628:therapy; D015774:Ganciclovir / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000276:immunology*; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D000998:Antiviral Agents; D015774:Ganciclovir