Optical coherence tomography in cytomegalovirus retinitis: A literature review

Background. Cytomegalovirus (CMV) retinitis is an inflammatory–necrotic disease that can lead to irreversible blindness. The cornerstone of diagnosis remains ophthalmoscopy. However, ophthalmoscopy is limited to direct visualization of retinal and choroidal changes, whereas optical coherence tomography (OCT) provides insight into structural alterations and spatial relationships within the vitreoretinochoroidal complex, thereby offering new diagnostic opportunities. Purpose: To systematize available data on the manifestations of CMV retinitis as assessed by OCT. Materials and methods. Publications were searched in PubMed, Google Scholar, Web of Science, and Scopus using the following keywords: “optical coherence tomography”, and “cytomegalovirus retinitis” (both in English and Russian); “retinal necrosis”, “ocular involvement in immunodeficiency”, “OCT angiography”, and “vitreoretinal interface” (in Russian only). Thirty publications describing the clinical features and case reports of CMV retinitis with OCT findings were selected. Results. This review summarizes distinguishing features between acute and resolved inflammation, differences in retinal perfusion in this patient group based on OCT angiography, and several hypotheses concerning the entry and intraocular dissemination of cytomegalovirus infection. Publications were structured according to OCT capabilities and study design, ranging from retrospective analyses of prior retinonecrosis cases to prospective investigations and disease monitoring using advanced OCT angiography techniques. Conclusion. OCT enables differentiation between active and inactive lesions of CMV retinitis and allows preclinical visualization of CMV-related changes within the eye.