Pizza pie appearance is seen in -
CYTOMEGALIC INCLUSION DISEASE It is a multisystem disease caused by cytomegalo-virus (CMV). It occurs in two forms: congenital and acquired. 1. Congenital cytomegalic inclusion disease. It affects the neonates. The infection is acquired eitheransplacentally in utero or during bih from the infected cervix of mother. Its common systemic features are sensory deafness, mental retardation and convulsions. Ocular involvement occurs in the form of peripheral,central or total necrotizing chorioretinitis with associated vitreous haze. Posterior pole is involved more commonly and the lesions may be similar to Those found in congenital toxoplasmosis. Secondary involvement of anterior uvea may occur rarely. 2. Acquired cytomegalic inclusion disease. It occurs only in the immunosuppressed patients (due to any cause). The infection may be acquired by droplet infection or by transfusion of fresh blood containing infected white cells. Ocular involvement is in the form of 'CMV retinitis' characterised by presence of yellow-white exudates (areas of retinal necrosis) associated with areas of vasculitis and retinal haemorrhages. Some eyes may develop exudative retinal detachment. Ultimately, there occurs total retinal atrophy. Treatment. There is no specific treatment of CID. Recently treatment with intravenous dihydroxy- propylmethyl guanine has been shown to cause regression in some cases. Ref comprehensive ophthalmology Ak Khurana 4/e page no 159.
Toxoplasmosis
Congenital rubella
Dyug toxicity
CMV retinitis
Vitreous and retina