Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive unilateral/bilateral blurred vision, scotoma, and floaters. History significant for immunocompromised state (e.g., HIV/AIDS, post-transplant, or immunosuppressive therapy). Denies ocular pain or photophobia. Duration of symptoms: [Insert duration].
Clinical Examination Findings
Slit-lamp biomicroscopy reveals minimal anterior chamber reaction. Dilated fundus examination shows characteristic "pizza pie" or "cottage cheese and ketchup" appearance: dense, confluent areas of white retinal necrosis with associated intraretinal hemorrhages and perivascular sheathing. Lesions located in [Peripheral/Posterior Pole]. No evidence of vitritis.
Treatment Protocol
Initiate systemic antiviral therapy (e.g., Valganciclovir, Ganciclovir, or Foscarnet). Consider intravitreal injections (Ganciclovir/Foscarnet) for sight-threatening lesions near the macula or optic nerve. Coordinate with Infectious Disease for optimization of systemic immune status (e.g., HAART therapy). Monitor for retinal detachment and systemic side effects.