Outcomes of cytomegalovirus retinitis-related retinal detachment surgery in acquired immunodeficiency syndrome patients in an Asian population

BMC Ophthalmol. 2014 Nov 27:14:150. doi: 10.1186/1471-2415-14-150.

Abstract

Background: This study reports the surgical outcomes of acquired immunodeficiency syndrome (AIDS) patients with Cytomegalovirus retinitis (CMVR) -related retinal detachments(RD) in an Asian population.

Methods: Review of CMVR characteristics, surgical outcomes and complications in 19 eyes with CMVR-related RD that underwent surgery from January 2000 to June 2011.

Results: CMVR was inactive in 73.7% of the eyes at time of surgery. Anatomical success was achieved in 14 eyes. Seven eyes (36.8%) had improvement of two or more lines in visual acuity (VA) and 8 eyes (42.1%) maintained VA. Thirteen eyes presented with worse than 6/120 vision, with 30.8% of them achieving ambulatory vision or better. Five eyes had re-detachments. Median durations from CMVR and immune recovery uveitis (IRU) diagnoses to RD were 2.7 and 1.0 months respectively.

Conclusions: Surgery for CMVR-related RD is associated with good anatomical outcomes with most eyes maintaining or having improved vision. CMVR lesion size of <50% retinal area is associated with better outcomes. Eyes with CMVR and IRU require close monitoring for RD.

MeSH terms

  • AIDS-Related Opportunistic Infections / complications*
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / ethnology
  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / ethnology
  • Adult
  • Antiretroviral Therapy, Highly Active
  • Antiviral Agents / therapeutic use
  • Asian People
  • CD4 Lymphocyte Count
  • Cytomegalovirus Retinitis / complications*
  • Cytomegalovirus Retinitis / drug therapy
  • Cytomegalovirus Retinitis / ethnology
  • Endotamponade
  • Female
  • Ganciclovir / analogs & derivatives
  • Ganciclovir / therapeutic use
  • Humans
  • Laser Coagulation
  • Male
  • Middle Aged
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Scleral Buckling
  • Treatment Outcome
  • Valganciclovir
  • Visual Acuity / physiology
  • Vitrectomy

Substances

  • Antiviral Agents
  • Valganciclovir
  • Ganciclovir