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Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis.

Almeida DR, Chin EK, Tarantola RM, Tegins EO, Lopez CA, Boldt HC, Gehrs KM, Sohn EH, Russell SR, Folk JC, Mahajan VB - Clin Ophthalmol (2015)

Bottom Line: Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater.Pars plana vitrectomy (n=12), silicone-oil tamponade (n=11), and scleral buckling (n=10) provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period.Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

ABSTRACT

Purpose: To determine the outcomes in patients with rhegmatogenous retinal detachment (RRD) secondary to viral retinitis.

Patients and methods: This was a retrospective, consecutive, noncomparative, interventional case series of 12 eyes in ten patients with RRD secondary to viral retinitis. Results of vitreous or aqueous biopsy, effect of antiviral therapeutics, time to retinal detachment, course of visual acuity, and anatomic and surgical outcomes were investigated.

Results: There were 1,259 cases of RRD during the study period, with 12 cases of RRD secondary to viral retinitis (prevalence of 0.95%). Follow-up was available for a mean period of 4.4 years. Varicella zoster virus was detected in six eyes, herpes simplex virus in two eyes, and cytomegalovirus in two eyes. Eight patients were treated with oral valacyclovir and two patients with intravenous acyclovir. Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater. Pars plana vitrectomy (n=12), silicone-oil tamponade (n=11), and scleral buckling (n=10) provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period.

Conclusion: Varicella zoster virus was the most frequent cause of viral retinitis, and lack of optic nerve involvement was predictive of a favorable visual acuity prognosis. Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes.

No MeSH data available.


Related in: MedlinePlus

Fundus drawings.Notes: Preoperative rhegmatogenous retinal detachment (RRD) cases secondary to acute retinal necrosis with the surgical procedures superimposed. (A and B) 28 year-old female with bilateral rhegmatogenous retinal detachment (RRD). (C) 33 year-old male with RRD and optic nerve involvement. (D) 60 year-old male with RRD but no optic nerve involvement. (E and F) Macula-on RRD with optic nerve involvement. (G and H) 24 year-old male with bilateral RRD. (I) 75 year-old female with RRD. (J) 67 year-old female with macula-on RRD and optic nerve involvement. (K) 66 year-old female with macula-off RRD. (L) 60 year-old male with macula-off RRD.Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye).
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f1-opth-9-1307: Fundus drawings.Notes: Preoperative rhegmatogenous retinal detachment (RRD) cases secondary to acute retinal necrosis with the surgical procedures superimposed. (A and B) 28 year-old female with bilateral rhegmatogenous retinal detachment (RRD). (C) 33 year-old male with RRD and optic nerve involvement. (D) 60 year-old male with RRD but no optic nerve involvement. (E and F) Macula-on RRD with optic nerve involvement. (G and H) 24 year-old male with bilateral RRD. (I) 75 year-old female with RRD. (J) 67 year-old female with macula-on RRD and optic nerve involvement. (K) 66 year-old female with macula-off RRD. (L) 60 year-old male with macula-off RRD.Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye).

Mentions: Macula-off RRD was found in 50% of cases (six of 12). Fundus drawings for all cases are shown in Figure 1, and display significant pathologic findings at time of surgery superimposed with operative surgical interventions. In our study, optic nerve involvement was diagnosed according to the proposed absolute and relative criteria for optic nerve involvement in viral retinitis. Absolute criteria include 1) afferent papillary defect not consistent with the retinal findings, 2) poor correlation between retinal findings and visual acuity, and 3) sudden deterioration of visual acuity to 20/100 or worse without corresponding retinal changes within a 24- to 36-hour interval.28 Optic nerve involvement occurred in 75% of cases (nine of 12). Lack of optic nerve involvement correlated with having a final visual acuity of better than 20/100: case 1, oculus sinister (OS [left eye]; final visual acuity 20/80); case 3 (final visual acuity 20/30); and case 6, OS (final visual acuity 20/70) (Tables 1 and 2).


Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis.

Almeida DR, Chin EK, Tarantola RM, Tegins EO, Lopez CA, Boldt HC, Gehrs KM, Sohn EH, Russell SR, Folk JC, Mahajan VB - Clin Ophthalmol (2015)

Fundus drawings.Notes: Preoperative rhegmatogenous retinal detachment (RRD) cases secondary to acute retinal necrosis with the surgical procedures superimposed. (A and B) 28 year-old female with bilateral rhegmatogenous retinal detachment (RRD). (C) 33 year-old male with RRD and optic nerve involvement. (D) 60 year-old male with RRD but no optic nerve involvement. (E and F) Macula-on RRD with optic nerve involvement. (G and H) 24 year-old male with bilateral RRD. (I) 75 year-old female with RRD. (J) 67 year-old female with macula-on RRD and optic nerve involvement. (K) 66 year-old female with macula-off RRD. (L) 60 year-old male with macula-off RRD.Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514312&req=5

f1-opth-9-1307: Fundus drawings.Notes: Preoperative rhegmatogenous retinal detachment (RRD) cases secondary to acute retinal necrosis with the surgical procedures superimposed. (A and B) 28 year-old female with bilateral rhegmatogenous retinal detachment (RRD). (C) 33 year-old male with RRD and optic nerve involvement. (D) 60 year-old male with RRD but no optic nerve involvement. (E and F) Macula-on RRD with optic nerve involvement. (G and H) 24 year-old male with bilateral RRD. (I) 75 year-old female with RRD. (J) 67 year-old female with macula-on RRD and optic nerve involvement. (K) 66 year-old female with macula-off RRD. (L) 60 year-old male with macula-off RRD.Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye).
Mentions: Macula-off RRD was found in 50% of cases (six of 12). Fundus drawings for all cases are shown in Figure 1, and display significant pathologic findings at time of surgery superimposed with operative surgical interventions. In our study, optic nerve involvement was diagnosed according to the proposed absolute and relative criteria for optic nerve involvement in viral retinitis. Absolute criteria include 1) afferent papillary defect not consistent with the retinal findings, 2) poor correlation between retinal findings and visual acuity, and 3) sudden deterioration of visual acuity to 20/100 or worse without corresponding retinal changes within a 24- to 36-hour interval.28 Optic nerve involvement occurred in 75% of cases (nine of 12). Lack of optic nerve involvement correlated with having a final visual acuity of better than 20/100: case 1, oculus sinister (OS [left eye]; final visual acuity 20/80); case 3 (final visual acuity 20/30); and case 6, OS (final visual acuity 20/70) (Tables 1 and 2).

Bottom Line: Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater.Pars plana vitrectomy (n=12), silicone-oil tamponade (n=11), and scleral buckling (n=10) provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period.Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

ABSTRACT

Purpose: To determine the outcomes in patients with rhegmatogenous retinal detachment (RRD) secondary to viral retinitis.

Patients and methods: This was a retrospective, consecutive, noncomparative, interventional case series of 12 eyes in ten patients with RRD secondary to viral retinitis. Results of vitreous or aqueous biopsy, effect of antiviral therapeutics, time to retinal detachment, course of visual acuity, and anatomic and surgical outcomes were investigated.

Results: There were 1,259 cases of RRD during the study period, with 12 cases of RRD secondary to viral retinitis (prevalence of 0.95%). Follow-up was available for a mean period of 4.4 years. Varicella zoster virus was detected in six eyes, herpes simplex virus in two eyes, and cytomegalovirus in two eyes. Eight patients were treated with oral valacyclovir and two patients with intravenous acyclovir. Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater. Pars plana vitrectomy (n=12), silicone-oil tamponade (n=11), and scleral buckling (n=10) provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period.

Conclusion: Varicella zoster virus was the most frequent cause of viral retinitis, and lack of optic nerve involvement was predictive of a favorable visual acuity prognosis. Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes.

No MeSH data available.


Related in: MedlinePlus