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Cytomegalovirus disease in immunocompetent adults

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To the Editor: We read with interest the review by Lancini and colleagues on cytomegalovirus (CMV) in immunocompetent patients.1 This topic and its associations with ocular disease has garnered increased recognition in the eye care community.

Clinically, CMV can cause an anterior uveitis (iritis) or, more rarely, retinitis, in otherwise healthy patients.2 The uveitis typically features a chronic and/or recurrent course with anterior segment inflammation, keratic precipitates, endotheliitis, iris atrophy and elevated intraocular pressure (IOP).3 CMV retinitis is characterised by confluent or semiconfluent areas of retinal whitening with haemorrhage.4

As with systemic CMV disease, oral valganciclovir appears to be effective treatment for ocular disease.35 CMV-associated ocular disease in immunocompetent adults is underdiagnosed due to low clinical suspicion and its capacity to mimic inflammatory eye disease associated with other Herpesviridae such as herpes simplex virus or varicella zoster virus.3,5 Misdiagnosis as other Herpesviridae can result in antiviral treatment that is…