![]() CMV retinitis in patients of NHL who have received prior chemotherapy or radiotherapy has been sparsely reported and most of the literature is confined to few case reports and needs to be studied in detail. Non-Hodgkin’s Lymphoma (NHL) is a reticuloendothelial cell carcinoma which needs multiple sessions of chemotherapy or radiotherapy. However, apart from AIDS, even malignancies and chemotherapies that target T cells are known to increase the risk of CMV disease. CMV retinitis is the most common ocular opportunistic infection and the leading cause of ocular morbidity associated with Acquired immunodeficiency syndrome (AIDS). The most common ocular features of CMV infection include hemorrhagic retinitis, vasculitis, and retinal necrosis. However, it can get reactivated in immunocompromised individuals resulting in several opportunistic infections. CMV remains latent in peripheral blood leukocytes and bone marrow cells of hosts. However, long-term control of CMV is predominantly through cell-mediated immunity. After entering the body, CMV is initially detected by the innate immune system via Toll-like receptors and Natural killer (NK) cells initiating a humoral response. The global prevalence of CMV is believed to be around 83% in the general population. These patients may require a long term maintenance in view of frequent recurrences after discontinuation of treatment.Ĭytomegalovirus (CMV) is a double-stranded DNA virus belonging to the family of Herpesviridae. ConclusionĬMV retinitis in NHL patients is usually of an indolent or granular type and can occur even in the presence of high CD4 counts as compared to patients with HIV. Two out of the 4 patients had a recurrence (mean time 33.8 days) after stopping the maintenance phase of ganciclovir and one patient had significant myelosuppression related to oral valganciclovir which required discontinuation of the drug. All patients had vitritis and majority of the patients (3 out of 4) had anterior chamber (AC) inflammation. Floaters were the commonest presenting complaint. Three patients had a presenting CD4 count above 150 cells/mm 3 and none of them were below 50 cells/mm 3. ![]() ![]() Granular or indolent retinitis (6 out of 7 eyes) was the commonest form of CMV retinitis in patients of NHL. MethodsĬlinical patterns of CMV Retinitis, CD4 counts at the time of presentation and the duration of treatment along with recurrences and time for recurrence of retinitis were assessed. Study designĪ retrospective chart review of seven eyes of four patients of NHL presenting with CMV retinitis between June 2017 and May 2020 was done. The aim of this study was to analyse the various patterns of presentations and outcomes of CMV Retinitis in patients with NHL. It, therefore, becomes important to understand its varied presentations and the challenges in management of these cases. Cytomegalovirus (CMV) retinitis in patients with Non-Hodgkin’s Lymphoma (NHL) can occur even in the presence of high CD 4 counts and can behave differently when compared to CMV retinitis in human immunodeficiency (HIV) patients. ![]()
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