Cytomegalovirus (CMV) Retinitis is caused by cytomegalovirus infection, which is a herpes-type virus that affects the retina of the human eye among patients having a weak immune system that could be due to conditions such as AIDS, leukemia and/or pregnancy. Symptomatic conditions include floaters, flashes, and blind spots besides loss of peripheral or blurred vision in the eyes of immune compromised patients.CMV infection often leads to hemorrhagic retinal inflammation along with vascular distribution. The CMV infection if left untreated spreads from one eye to the other, eventually leading to visual loss and/or complete blindness. Therefore, prompt diagnosis through blood as well as urine tests besides other optical tests that involve withdrawal of a small specimen fluid from the infected eye is recommended.
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Global CMV retinitis market can be segmented on the basis of anti-CMV drugs or anti-infective ophthalmic drugs into Foscarnet, Ganciclovir, Cidofovir, Fomivirsen and others. In the anti-CMV drugs segment, various off-label drugs are also being used, however many of these drugs have serious contraindications. In this market segment, one of the key challenges is drug resistance which needs to be counterfeited with clinical trials and pipeline drugs. For instance, intraocular Fomivirsen has been found to prevent CMV retinitis during clinical trials. Further, the CMV retinitis market can also be segmented on the basis of available therapeutic treatments into anti-CMV Oral Ganciclovir, anti-CMV Intravenous drug therapy, anti-CMV Intraocular (local), and anti-HIV Systemic and Retinal Detachment through Vitrectomy. Oral therapy is relatively more convenient and recommended for peripheral retinitis cases but not for later stages of CMV retinitis when the condition becomes visually threatening.
Intravenous therapy treats the infection along with protecting the eye against systemic infection. Furthermore, higher longevity has been observed with Foscarnet in comparison to Ganciclovir. Intraocular therapy is highly effective in controlling infection, and is relatively less costly than systemic and superior to intravenous. However, intraocular implants need replacement after a duration of 6-8 months, especially among those having lower levels of T-helper cell counts. Systemic treatment is directed towards the HIV virus through a combination of reverse transcriptase and protease inhibitors, which is a highly active anti-retroviral therapy to restore immune system besides raising the T-helper cell counts.
Geographically, North America (U.S and Canada) dominate the CMV Retinitis market followed by Europe as leading manufacturers of CMV Retinitis are domiciled in these regions having majority of their operations in the local regional markets. However, Asia Pacific, Africa as well as Latin America would also prove to be the highly profitable markets in the future due to the high prevalence rates for immunodeficiency diseases in these regions.
Taking into consideration the staggering figures of around 33,400,000 persons living with HIV infection, who are highly susceptible to the CMV retinitis condition globally, this specialized and niche market is estimated to escalate at a high pace. However, some of the restraints in this foresighted growth would include the newer anti-HIV medications, which prevent occurrence of this disease. Moreover, since this disease is largely concentrated to patients with pre-existing conditions such as HIV the overall size of the market will be smaller as CMV retinitis occur in approximately 46% of the HIV patients in comparison with other common diseases.
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Some of the major players that are currently operating in this market include Bausch & Lomb Incorporated, CSL Behring, Emcure Pharms, Ltd., Endo Pharmaceuticals, Inc., F. Hoffmann-La Roche Ltd., Hospira, Inc., Luitpold Pharmaceuticals, Inc., Mylan N.V., and Valeant Pharmaceuticals International, Inc. among others.
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