Clinical, molecular, and immunologic mechanisms of CMV retinitis: Evolving understanding in HIV and non-HIV immunosuppressed patients.

Introduction: Rates of CMV retinitis (CMVR) resulting from HIV have declined following the advent of highly active antiretroviral therapy (HAART); however, other immunosuppressed populations are becoming increasingly affected by CMVR. More research is required to identify and target differences found in these patients, as they may represent a promising avenue for targeted treatment therapy. Areas covered: This review includes information from studies on the prevalence, pathophysiology, and clinical manifestations of CMV and CMVR. It also discusses the impact of antiretroviral therapy on CMVR incidence, explores various risk factors, and examines the molecular mechanisms and immune responses associated with CMV infection. Additionally, the article discusses diagnostic considerations, treatment strategies, and the potential for new therapeutic approaches. Expert opinion: Cytomegalovirus retinitis (CMVR) remains a major cause of vision loss in immunocompromised individuals. CMVR presents differently in HIV-positive and HIV-negative patients, suggesting a possible variation in underlying pathophysiology between the two groups. More research is needed to characterize the potential differences in molecular mechanisms, immunopathology, and genetic markers implicated in the development of CMVR in these populations to develop targeted therapies.