International consensuses and guidelines on diagnosing and managing cytomegalovirus (CMV) retinitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)
Issued Date
2025-09-01
Resource Type
eISSN
21620989
Scopus ID
2-s2.0-105022066150
Pubmed ID
41038280
Journal Title
Asia Pacific Journal of Ophthalmology
Volume
14
Issue
5
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asia Pacific Journal of Ophthalmology Vol.14 No.5 (2025)
Suggested Citation
Hwang D.K., Ng D.S.C., Qian Z., Agrawal R., Chan A.S.Y., Chhablani J., Choopong P., Gupta V., Invernizzi A., McCluskey P., Lee C.S., Natarajan S., La Distia Nora R., Ocampo V.V., Singh R., Somkijrungroj T., Sonoda K.H., Wei W., Wong I.Y.H., Lam D.S.C., Tao Y. International consensuses and guidelines on diagnosing and managing cytomegalovirus (CMV) retinitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII). Asia Pacific Journal of Ophthalmology Vol.14 No.5 (2025). doi:10.1016/j.apjo.2025.100248 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113213
Title
International consensuses and guidelines on diagnosing and managing cytomegalovirus (CMV) retinitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)
Author's Affiliation
Chinese University of Hong Kong
University of Pittsburgh School of Medicine
Erasmus MC
Yonsei University College of Medicine
National Yang-Ming University Taiwan
Postgraduate Institute of Medical Education and Research, Chandigarh
Faculty of Medicine and Health
Taipei Veterans General Hospital
Graduate School of Medical Sciences
Duke-NUS Medical School
Siriraj Hospital
The Chinese University of Hong Kong, Shenzhen
Beijing Chao-Yang Hospital, Capital Medical University
Beijing Tongren Hospital, Capital Medical University
Ospedale Luigi Sacco - Polo Universitario
Tan Tock Seng Hospital
Lee Kong Chian School of Medicine
Singapore Eye Research Institute
Sri Ramachandra Institute of Higher Education and Research
King Chulalongkorn Memorial Hospital
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Faculty of Medicine, Chulalongkorn University
Singapore National Eye Centre
Save Sight Institute
Hong Kong Sanatorium and Hospital
Universidad Maimonides
Lokmanya Tilak Municipal General Hospital
Aditya Jyot Eye Hospital Pvt. Ltd.
Asian Hospital and Medical Center, Muntinlupa
C-MER (Shenzhen) Dennis Lam Eye Hospital
C-MER Dennis Lam & Partners Eye Center
Beijing GIANTMED Medical Diagnostics Lab
C+ Health CKJ (Shenzhen) Hospital
Kamala Sundaram Foundation
Sundaram Natarajan Blind Free India Foundation
University of Pittsburgh School of Medicine
Erasmus MC
Yonsei University College of Medicine
National Yang-Ming University Taiwan
Postgraduate Institute of Medical Education and Research, Chandigarh
Faculty of Medicine and Health
Taipei Veterans General Hospital
Graduate School of Medical Sciences
Duke-NUS Medical School
Siriraj Hospital
The Chinese University of Hong Kong, Shenzhen
Beijing Chao-Yang Hospital, Capital Medical University
Beijing Tongren Hospital, Capital Medical University
Ospedale Luigi Sacco - Polo Universitario
Tan Tock Seng Hospital
Lee Kong Chian School of Medicine
Singapore Eye Research Institute
Sri Ramachandra Institute of Higher Education and Research
King Chulalongkorn Memorial Hospital
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Faculty of Medicine, Chulalongkorn University
Singapore National Eye Centre
Save Sight Institute
Hong Kong Sanatorium and Hospital
Universidad Maimonides
Lokmanya Tilak Municipal General Hospital
Aditya Jyot Eye Hospital Pvt. Ltd.
Asian Hospital and Medical Center, Muntinlupa
C-MER (Shenzhen) Dennis Lam Eye Hospital
C-MER Dennis Lam & Partners Eye Center
Beijing GIANTMED Medical Diagnostics Lab
C+ Health CKJ (Shenzhen) Hospital
Kamala Sundaram Foundation
Sundaram Natarajan Blind Free India Foundation
Corresponding Author(s)
Other Contributor(s)
Abstract
With the paradigm changes in antiviral therapy, there are a myriad of emerging controversies in the management of cytomegalovirus retinitis (CMVR). A certain extent of variability exists in the management of CMVR among clinical practices worldwide. Hence, alignment in the management strategy is important towards optimizing the care of CMVR. An international panel of experts (IPE) formulated consensus statements for CMVR regarding to its 1) diagnosis, 2) screening, 3) treatment, 4) management in special populations and 5) emerging technologies. The clinical diagnosis of CMVR relies on patient’s susceptibility due to compromised immune function and characteristic fundus manifestations. Polymerase chain reaction (PCR) of intraocular fluid for detection of CMV is indicated when confirmation is necessary. Oral valganciclovir is the preferred first-line treatment, and intravitreal ganciclovir injection when CMVR threatens to involve the posterior pole. Cessation of maintenance treatment can be considered after 6 months when CMVR remains inactive with immune reconstitution. Immune recovery uveitis (IRU) must be distinguished from CMVR relapse. Screening is recommended for high risk cases. Utilization of telemedicine and artificial intelligence-aided interpretation will help to alleviate the resources required for CMVR screening. Evidence for novel antiviral and immunotherapy have been appraised as second-line treatment options.