Intravitreal hemorrhages are more commonly associated with CMV than with Toxoplasmosis.

Intravitreal hemorrhages are more commonly associated with CMV than with Toxoplasmosis.

• A. Toxoplasmosis
• B. CMV
• C. Neither
• D. Both

Answer: (B)

Intravitreal hemorrhages come from CMV retinitis because CMV causes necrotizing retinitis with prominent vascular involvement and bleeding along the retina, leading to a hemorrhagic, “pizza pie” appearance especially in immunocompromised eyes. Toxoplasma retinochoroiditis, by contrast, classically presents as a focal white necrotizing lesion with dense overlying vitreous inflammation; the hallmark sign is the “headlight in a fog” due to vitritis, and retinal hemorrhages are not the defining feature. So the pattern of hemorrhage points more toward CMV than toxoplasmosis. If you see a lot of intraretinal or retinal hemorrhages with necrosis in an at-risk patient, CMV retinitis is the better fit.

Intravitreal hemorrhages come from CMV retinitis because CMV causes necrotizing retinitis with prominent vascular involvement and bleeding along the retina, leading to a hemorrhagic, “pizza pie” appearance especially in immunocompromised eyes. Toxoplasma retinochoroiditis, by contrast, classically presents as a focal white necrotizing lesion with dense overlying vitreous inflammation; the hallmark sign is the “headlight in a fog” due to vitritis, and retinal hemorrhages are not the defining feature. So the pattern of hemorrhage points more toward CMV than toxoplasmosis. If you see a lot of intraretinal or retinal hemorrhages with necrosis in an at-risk patient, CMV retinitis is the better fit.