ABSTRACT

OUTCOME OF CYTOMEGALOVIRUS NEURORETINITIS IN AN HIV PATIENT

WITH ORAL VALGANCYCLOVIR
Juliari IGA Made
Externals Disease and Immunology Division
Ophthalmology Medicine Departments
Udayana University Faculty of Medicine, Denpasar

Purpose : To evaluate efficacy oral valgancyclovir in patient with neuroretinitis CMV.

Introduction and Objective : Cytomegalovirus (CMV) is a neurotropic virus with predilection
to the retina and central nervous system. CMV is the most common ocular opportunistic infection
in patients with advanced human immunodeficiency virus (HIV) and usually when CD4+ T-cell
counts are less than 50/L.3 CMV retinitis can be treated with ganciclovir or valgancyclovir
administered systemically or intravitreally.
Methods : A 29-year-old man was detected to be HIV positive in February 2016, Since 1 month
ago complain blurry vision in his left eye and sometime he see black shadow inside the eye,
painless and no history to redness. On ocular examination, his vision in the left eye (LE) light
perception bad projection, positive relative afferent pupillary defect in LE and fundus examination
LE found optic disk swelling, hemorrhage and retina exudate and flame shape hemorrhage, CD4
absolute 4.0 cell/L. After induction therapy VA LE improve 2 meter counting finger and in
fundus finding reduced optic disk swelling, retinal exudate and flame shape hemorrhage was
decrease.
Result : Oral valgancyclovir can decrease retinal exudate and hemorrhage, reduced optic disk
swelling and result visual acuity improvement.
Conclusion : Oral valgancyclovir give good prognosis for decrease progression CMV.

Keyword : Cytomegalovirus neuroretinitis, human immunodeficiency virus, , oral valgancyclovir