Cytomegalovirus retinitis in HIV-negative patients - associated conditions, clinical presentation, diagnostic methods and treatment strategy

Acta Ophthalmol. 2018 Nov;96(7):e761-e767. doi: 10.1111/aos.13553. Epub 2017 Oct 25.


In recent years, numerous reports have tied cytomegalovirus retinitis (CMVR) with multiple systemic conditions in the absence of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). These range from reports in apparently healthy individuals, through conditions rendering limited immune dysfunction such as advanced age and diabetes mellitus, and finally severe immune dysfunction such as in haematological and rheumatological conditions. Reports are also emerging, suggesting that induced local ocular immunosuppression is a risk factor for CMVR. We herein present a comprehensive collection of the accumulated findings regarding CMVR in non-HIV patients. We summarize the spectrum of underlying morbidity that has been associated with CMVR, its clinical presentation, diagnostic methods and treatment choice in the attempt to suggest the optimal treatment strategy in this complicated and diverse patient population which is still currently lacking a consensus.

Keywords: HIV negative; cytomegalovirus retinitis; healthy; intravitreal injection; paediatric; treatment.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Aqueous Humor / virology
  • Cytomegalovirus / genetics
  • Cytomegalovirus Retinitis / diagnosis*
  • Cytomegalovirus Retinitis / drug therapy*
  • Cytomegalovirus Retinitis / immunology
  • Diagnostic Techniques, Ophthalmological*
  • HIV Seronegativity*
  • Humans
  • Polymerase Chain Reaction / methods
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification
  • Vitreous Body / virology


  • Antiviral Agents
  • RNA, Viral