<prompt> All are seen in CMV retinitis except -ImmunosuppressionBrush-fire appearanceVitreous hemorrhagePerivasculitis  <response>: Ans. is None c i.e., Vitreous hemorrhage o CMV retinitis is the most common ophthalmic manifestation of CMV, occuring as a congenital infection in infants or an opportunistic infection in the immunocompromised host,o Adults commonly affected include those individuals with acquired immunodeficiency syndrome AIDS, oncology patients, and patients on immunosuppresive therapy,o There is characteristic hemorrhagic, full thickness retinitis.o In early stage there are yellow-white exudates areas of retinal necrosis associated with areas of vasculitis and retinal hemorrhage.o There may be exudative retinal detachment and ultimately, there occurs total retinal atrophy.o There are three distinct variants of CMV retinitisClassical fulminant retinitisIt is necrotic retinitisLarge areas of retinal hemorrhage along a whitened, edematous or necrotic retina, usually in posterior pole inthe distribution of nerve fiber layer along the vascular arcades.It is also known as Pizza-Pic retinopathy or cottage cheese with catchup.Granular indolent retinitisWithout edema, hemorrhage or vascular sheathing, progressing along active border of retinal periphery.Perivascular retinitisFrosted branch angitis with retinal perivasculitis.o Another finding in CMV retinitis is a white granular geographic lesion that clears centrally as it enlarges, leaving a quiet central area of retinal atrophy and mottled pigment epithelium. This has also been described as brush-fire pattern.o It should be remembered that vitreous hemorrhage, though, is not common in CMV retinitis, it may occur after initiation of treatment of AIDS HA ART.o In routine course there is no vireous hemorrhage or vitritis due to immunocompromised state of these patients. But, once the treatment of AIDS is started, their immune status may improve, and capable of producing inflammation. Which may cause vitritis and vitreous hemorrhage. 