Probable Cytomegalovirus Retinitis as the Presenting Manifestation of Newly Diagnosed HIV Infection

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    • By Pablo Angel García-Uribe, MD, PhD
      Clínica Oftalmológica Salauno
      Co-author(s): Gottlinda Payán-González, MD, Ophthalmologist and Uveitis Specialist, Clínica Oftalmológica Salauno, Mexico City
    • Uploaded on Sep 29, 2026.
    • Last modified by Joshua Friedman on Oct 2, 2026.
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    Appears in
    Cytomegalovirus Retinitis
    Condition/keywords
    cytomegalovirus (CMV), Cytomegalovirus Retinitis, retinitis, infectious uveitis
    Photographer
    David García-García, Optometrist, Clínica Oftalmológica Salauno, Mexico City
    Imaging device
    Fundus camera
    VISUCAM 524(Carl Zeiss Meditec AG, Jena, Germany)
    Description
    A 45-year-old patient was referred to the Uveitis Service for presumed cytomegalovirus (CMV) retinitis in the right eye. Medical history was notable for chronic diarrhea, 15-kg unintentional weight loss, and hair loss. Visual acuity was 20/100 OD, improving to 20/50 with pinhole. Wide-field fundus photography showed a large area of necrotizing retinitis along the superior temporal vascular arcade, with retinal whitening, vascular sheathing, and intraretinal hemorrhages, while the macula remained uninvolved. The fellow eye was unremarkable. HIV-1 testing was positive, raising concern for an opportunistic retinal infection in the setting of immunosuppression. CMV retinitis was considered the leading diagnosis, and the patient was urgently referred for tertiary infectious disease and ophthalmologic management.

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