Clinical Features of Newly Diagnosed Cytomegalovirus Retinitis in South India

Background: The clinical features of cytomegalovirus (CMV) retinitis have not been well-characterized in India, despite the likely high burden of disease. Setting: Tertiary eye hospital in Madurai, India. Methods: All patients with a diagnosis of CMV retinitis seen at a single eye hospital from 2007 to 2023 were identified from Uvea, Retina, and Microbiology registries and the hospital administrative database. A standardized chart review was performed. Results: Among 343 patients diagnosed with CMV retinitis, 322 (94%) were HIV-positive. Of 213 patients with a documented date of HIV diagnosis, 54 (25%) were unaware of their HIV status until after being diagnosed with CMV retinitis. Of the 159 HIV-positive patients aware of their diagnosis, 33 (21%) were not yet taking antiretroviral therapy at the time of retinitis diagnosis. At the time of CMV retinitis diagnosis a total of 52 (16%) patients were bilaterally blind and 57 (18%) had retinal detachment in one or both eyes. The number of patients presenting with CMV retinitis each year did not change substantially between 2007 and 2023. Conclusion: Patients diagnosed with CMV retinitis at an eye hospital in South India presented with advanced disease, and were frequently unaware of their HIV diagnosis.