Purpose To describe the characteristics and outcomes of patients with cytomega lovirus (CMV) retinitis in the absence of human immunodeficiency virus (HIV) inf ection. Design Retrospective cohort study. Methods Consecutive patients with CMV retinitis in the absence of HIV infection were identified at a university hospi tal. Demographic and clinical characteristics were noted at the time of CMV reti nitis. Outcomes were determined retrospectively. Main outcome measures were rate s of second eye involvement, vision loss, rhegmatogenous retinal detachment (RD) , immune recovery uveitis, progression of retinitis, and mortality. Results The clinical characteristics of CMV retinitis in 18 patients (30 eyes) without HIV i nfection diagnosed between January 1, 1984, and April 13, 2003, were similar to those of patients with HIV infection. The incidences of visual loss to the level s of 20/50 or worse and of 20/200 or worse were 17%per eye-year and 14%per ey e-year, respectively. The observed incidence of RD was 3.7%per eye-year, and the mortality rate was 23%per person-year. Following reduction of immunosuppre ssion, 10 patients (56%) who discontinued anti-CMV therapy remained free of re tinitis progression. The incidence of immune recovery uveitis was 13%per person year. Conclusions In our series, CMV retinitis in patients without HIV infectio n had a clinical course similar to that in patients with AIDS treated with highl y active antiretroviral therapy (HAART), except the incidence of RD was lower for patients without AIDS. A substantial number of patients no longer re quired long-term anti-CMV therapy after adjustment of immunomodulatory therapy . Purpose To describe the characteristics and outcomes of patients with cytomega lovirus (CMV) retinitis in the absence of human immunodeficiency virus (HIV) inf ection. Design Retrospective cohort study. Methods Consecutive patients with CMV retinitis in the absence of HIV infection were identified at a Demographic and clinical characteristics were noted at the time of CMV reti nitis. Outcomes were determined retrospectively. Main outcome measures were rate s of second eye involvement, vision loss, rhegmatogenous retinal detachment (RD), immune recovery uveitis, progression of Results The clinical characteristics of CMV retinitis in 18 patients (30 eyes) without HIV i nfection diagnosed between January 1, 1984, and April 13, 2003, were similar to those of patients with HIV infection. The incidences of visual loss to the level s of 20/50 or worse and of 20/200 or worse were 17% per eye-year and 14% per ey e-year, respectively. The observed i ncidence of RD was 3.7% per eye-year, and the mortality rate was 23% per person-year. Following reduction of immunosuppre ssion, 10 patients (56%) who discontinued anti-CMV therapy remained free of re tinitis progression. The incidence of immune recovery uveitis was 13% per person year. Conclusions In our series, CMV retinitis in patients without HIV infectio n had a clinical course similar to that in patients with AIDS treated with high active antiretroviral therapy (HAART), except the incidence of RD was lower for patients without AIDS. A substantial number of patients no longer re quired long-term anti-CMV therapy after adjustment of immunomodulatory therapy.