Impression: Localized CMV Retinitis OS
The diagnosis of CMV Retinitis in this HIV positive male with a low CD4 count was never in doubt. The question is how best to treat this patient.
Treatment options include:
- Induction with IV Ganciclovir
- Induction with IV Foscarnet
- Intraocular Ganciclovir pellet implant with or without oral Ganciclovir
Treatment Plan
The patient was treated with induction therapy using IV Ganciclovir for 2 weeks BID, followed by maintenance QD. On examination 2 months after treatment began, the patient noted HAVING photopsia for 1 week.
Vision: 20/40 OD, 20/20 OS Pupils: Equal, reactive, No APD Motility: Full OU Applanation pressure: 14 OD, 10 OS Slit lamp examination: Normal OU Deep/Quiet OU Fundus examination: See Figures 2a-2b Impression: Progression of CMV Retinitis OS
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