Therapy and Prevention of Cytomegalovirus Retinitis.

Highly active antiretroviral therapy (HAART) has redefined the natural history of cytomegalovirus (CMV) retinitis. Once a major cause of blindness in AIDS patients, its incidence has plummeted and its clinical course has been altered. The potential of HAART for immunologic restoration should guide treatment decisions, and may ultimately lead to the possibility of withdrawal from maintenance anti-CMV therapy. However, new cases of CMV retinitis have begun to emerge in virologic and immunologic failures to HAART. The impact of HAART continues to evolve with the discovery of sight-threatening immune recovery uveitis. Specific anti-CMV treatment strategies have expanded and improved to include therapeutic options not requiring the parenteral route of administration such as valganciclovir, which has enhanced oral bioavailability.