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. 1995 Jun;79(6):575–580. doi: 10.1136/bjo.79.6.575

Retinal detachment and herpesvirus retinitis in patients with AIDS.

J G Dowler 1, H M Towler 1, S M Mitchell 1, R J Cooling 1, S L Lightman 1
PMCID: PMC505169  PMID: 7626574

Abstract

BACKGROUND--The prolongation of survival of patients with herpesvirus retinitis and AIDS has been associated with a rise in the incidence of retinal detachment. In such cases, however, retinal reattachment may be difficult to achieve, and postoperative visual acuity may be poor despite anatomically successful surgery. METHODS--In order to examine factors affecting the visual outcome of surgery, a retrospective review of 29 patients with retinal detachment, herpesvirus retinitis, and AIDS was performed. Retinal reattachment surgery (32 procedures) or prophylactic laser demarcation (five procedures) was performed in 28 eyes of 23 patients. RESULTS--The macula was attached in 23/28 (82%) eyes at the last outpatient visit. Best postoperative visual acuity (median 6/18, range 6/6-hand movements) was significantly greater than final postoperative acuity (median counting fingers, range 6/6-no perception of light) (Wilcoxon sign rank test, p = 0.003), and was retained for a median of 3 months (1-91 weeks) after surgery. Poor visual outcome as evidenced by submedian final visual acuity was invariably associated with persistence of macular detachment, and significantly associated with the occurrence of optic atrophy (odds ratio = 5, p = 0.02). CONCLUSION--Retinal reattachment surgery appears justified in patients with herpesvirus retinitis and AIDS, but postoperative visual deterioration may occur in association with optic atrophy.

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Selected References

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  1. Chan C., Okun E. The question of ocular tolerance to intravitreal liquid silicone. A long-term analysis. Ophthalmology. 1986 May;93(5):651–660. doi: 10.1016/s0161-6420(86)33685-6. [DOI] [PubMed] [Google Scholar]
  2. Chuang E. L., Davis J. L. Management of retinal detachment associated with CMV retinitis in AIDS patients. Eye (Lond) 1992;6(Pt 1):28–34. doi: 10.1038/eye.1992.4. [DOI] [PubMed] [Google Scholar]
  3. Dugel P. U., Liggett P. E., Lee M. B., Ziogas A., Forster D. J., Smith R. E., Rao N. A. Repair of retinal detachment caused by cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol. 1991 Sep 15;112(3):235–242. doi: 10.1016/s0002-9394(14)76723-6. [DOI] [PubMed] [Google Scholar]
  4. Fabricius E. M., Möller A. A., Prantl F. Erkrankungen der afferenten Sehbahn bei HIV-Infektion. 1. Sehnerv und 2. Sehstrahlung/Sehrinde. Fortschr Ophthalmol. 1991;88(6):721–730. [PubMed] [Google Scholar]
  5. Freeman W. R., Henderly D. E., Wan W. L., Causey D., Trousdale M., Green R. L., Rao N. A. Prevalence, pathophysiology, and treatment of rhegmatogenous retinal detachment in treated cytomegalovirus retinitis. Am J Ophthalmol. 1987 Apr 15;103(4):527–536. doi: 10.1016/s0002-9394(14)74276-x. [DOI] [PubMed] [Google Scholar]
  6. Freeman W. R., Quiceno J. I., Crapotta J. A., Listhaus A., Munguia D., Aguilar M. F. Surgical repair of rhegmatogenous retinal detachment in immunosuppressed patients with cytomegalovirus retinitis. Ophthalmology. 1992 Mar;99(3):466–474. doi: 10.1016/s0161-6420(92)31976-1. [DOI] [PubMed] [Google Scholar]
  7. Gross J. G., Sadun A. A., Wiley C. A., Freeman W. R. Severe visual loss related to isolated peripapillary retinal and optic nerve head cytomegalovirus infection. Am J Ophthalmol. 1989 Dec 15;108(6):691–698. doi: 10.1016/0002-9394(89)90863-5. [DOI] [PubMed] [Google Scholar]
  8. Holland G. N., Sison R. F., Jatulis D. E., Haslop M. G., Sakamoto M. J., Wheeler N. C. Survival of patients with the acquired immune deficiency syndrome after development of cytomegalovirus retinopathy. UCLA CMV Retinopathy Study Group. Ophthalmology. 1990 Feb;97(2):204–211. doi: 10.1016/s0161-6420(90)32616-7. [DOI] [PubMed] [Google Scholar]
  9. Holland G. N. The management of retinal detachments in patients with acquired immunodeficiency syndrome. Arch Ophthalmol. 1991 Jun;109(6):791–793. doi: 10.1001/archopht.1991.01080060055023. [DOI] [PubMed] [Google Scholar]
  10. Irvine A. R. Treatment of retinal detachment due to cytomegalovirus retinitis in patients with AIDS. Trans Am Ophthalmol Soc. 1991;89:349–367. [PMC free article] [PubMed] [Google Scholar]
  11. Jabs D. A., Enger C., Bartlett J. G. Cytomegalovirus retinitis and acquired immunodeficiency syndrome. Arch Ophthalmol. 1989 Jan;107(1):75–80. doi: 10.1001/archopht.1989.01070010077031. [DOI] [PubMed] [Google Scholar]
  12. Jabs D. A., Enger C., Haller J., de Bustros S. Retinal detachments in patients with cytomegalovirus retinitis. Arch Ophthalmol. 1991 Jun;109(6):794–799. doi: 10.1001/archopht.1991.01080060058024. [DOI] [PubMed] [Google Scholar]
  13. Jabs D. A., Schachat A. P., Liss R., Knox D. L., Michels R. G. Presumed varicella zoster retinitis in immunocompromised patients. Retina. 1987 Spring;7(1):9–13. [PubMed] [Google Scholar]
  14. Kuppermann B. D., Flores-Aguilar M., Quiceno J. I., Capparelli E. V., Levi L., Munguia D., Freeman W. R. A masked prospective evaluation of outcome parameters for cytomegalovirus-related retinal detachment surgery in patients with acquired immune deficiency syndrome. Ophthalmology. 1994 Jan;101(1):46–55. doi: 10.1016/s0161-6420(94)31383-2. [DOI] [PubMed] [Google Scholar]
  15. Lim J. I., Enger C., Haller J. A., Campochiaro P. A., Meredith T. A., de Bustros S., Dunn J. P., Jabs D. A. Improved visual results after surgical repair of cytomegalovirus-related retinal detachments. Ophthalmology. 1994 Feb;101(2):264–269. doi: 10.1016/s0161-6420(13)31339-6. [DOI] [PubMed] [Google Scholar]
  16. Orellana J., Teich S. A., Lieberman R. M., Restrepo S., Peairs R. Treatment of retinal detachments in patients with the acquired immune deficiency syndrome. Ophthalmology. 1991 Jun;98(6):939–943. doi: 10.1016/s0161-6420(91)32217-6. [DOI] [PubMed] [Google Scholar]
  17. Regillo C. D., Vander J. F., Duker J. S., Fischer D. H., Belmont J. B., Kleiner R. Repair of retinitis-related retinal detachments with silicone oil in patients with acquired immunodeficiency syndrome. Am J Ophthalmol. 1992 Jan 15;113(1):21–27. doi: 10.1016/s0002-9394(14)75747-2. [DOI] [PubMed] [Google Scholar]
  18. Sergott R. C., Anand R., Belmont J. B., Fischer D. H., Bosley T. M., Savino P. J. Acute retinal necrosis neuropathy. Clinical profile and surgical therapy. Arch Ophthalmol. 1989 May;107(5):692–696. doi: 10.1001/archopht.1989.01070010710032. [DOI] [PubMed] [Google Scholar]
  19. Sidikaro Y., Silver L., Holland G. N., Kreiger A. E. Rhegmatogenous retinal detachments in patients with AIDS and necrotizing retinal infections. Ophthalmology. 1991 Feb;98(2):129–135. [PubMed] [Google Scholar]
  20. Vrabec M. P., McCanna P. J. The effect of topically applied fluorescein on fluorescent monoclonal antibodies in the diagnosis of chlamydial conjunctivitis. Ann Ophthalmol. 1988 Nov;20(11):421–423. [PubMed] [Google Scholar]
  21. Winward K. E., Hamed L. M., Glaser J. S. The spectrum of optic nerve disease in human immunodeficiency virus infection. Am J Ophthalmol. 1989 Apr 15;107(4):373–380. doi: 10.1016/0002-9394(89)90660-0. [DOI] [PubMed] [Google Scholar]

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