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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Eye on cytomegalovirus: Unveiling the ophthalmic impact of cytomegalovirus
Mutali Musa, Gladness Aluyi-Osa, Ekele Chukwuyem, Babatunde Ismail Bale, Fabiana D’Esposito, Daniele Tognetto, Caterina Gagliano, Marco Zeppieri
Mutali Musa, Gladness Aluyi-Osa, Ekele Chukwuyem, Department of Ophthalmology, Africa Eye Laser Center Ltd., Benin 300211, Nigeria
Mutali Musa, Babatunde Ismail Bale, Department of Optometry, University of Benin, Benin 300283, Nigeria
Fabiana D’Esposito, Imperial College Ophthalmic Research Group Unit, Imperial College, London NW15QH, United Kingdom
Fabiana D’Esposito, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli 80131, Italy
Daniele Tognetto, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34129, Italy
Caterina Gagliano, Department of Medicine and Surgery, University of Enna "Kore", Catania 94100, Italy
Caterina Gagliano, Mediterranean Foundation, "G.B. Morgagni", Catania 95125, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Co-corresponding authors: Caterina Gagliano and Marco Zeppieri.
Author contributions: Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing; Musa M, Aluyi-Osa G, Chukwuyem E, Bale BI and Zeppieri M wrote the outline; Musa M, Aluyi-Osa G, Chukwuyem E and Zeppieri M conducted the research and writing of the manuscript; Musa M, Chukwuyem E, D’Esposito F, Tognetto D, Gagliano C, and Zeppieri M assisted in the writing of the draft and final paper; Musa M, Aluyi-Osa G, Chukwuyem E, Bale BI, D’Esposito F, Tognetto D, Gagliano C, and Zeppieri M assisted in the editing, making critical revisions of the manuscript and viewing all versions of the manuscript; all authors provided the final approval of the article.
Conflict-of-interest statement: The authors have no conflicts of interests to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, Maria della Misericordia 15, Udine 33100, Italy.
mark.zeppieri@asufc.sanita.fvg.it
Received: October 8, 2024
Revised: November 14, 2024
Accepted: December 12, 2024
Published online: June 25, 2025
Processing time: 263 Days and 22.3 Hours
BACKGROUND
Cytomegalovirus (CMV) is a ubiquitous herpesvirus that can cause significant ocular morbidity, particularly in immunocompromised individuals.
AIM
To summarize the current understanding of the ophthalmic impact of CMV, with a focus on its epidemiology, clinical manifestations, diagnosis, and management, ocular symptoms of CMV floaters, blurred vision, and loss of peripheral vision, eventually progressing to retinal necrosis and detachment. CMV retinitis (CMVR) is a sight-threatening condition that can lead to retinal detachment, blindness, and even death.
METHODS
We discuss the pathophysiology of CMVR, including the role of immune suppression and viral reactivation. We also examine the clinical features of CMVR, including its characteristic retinal lesions and associated ocular complications. Diagnostic approaches are reviewed, including polymerase chain reaction and fundus photography.
RESULTS
We discuss treatment options, including antiviral medications, intravitreal injections, and surgical interventions. Finally, we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.
CONCLUSION
CMV poses a significant threat to ocular health, particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.
Core Tip: Cytomegalovirus (CMV) retinitis is a severe eye infection that primarily impacts immunocompromised individuals, leading to symptoms like blurred vision, blind spots, floaters, and potential retinal detachment, which can result in blindness. Diagnosis involves an eye examination, blood tests to detect CMV antibodies or viral DNA, and imaging techniques such as fundus photography and optical coherence tomography. Treatment includes antiviral medications such as ganciclovir, valganciclovir, foscarnet, and cidofovir, as well as potential laser surgery to repair retinal detachment. Strengthening the immune system with antiretroviral therapy is crucial for managing the infection in people with human immunodeficiency virus/acquired immune deficiency syndrome.
