Cytomegalovirus retinitis (CMVR)-related retinal detachment (RD) surgery in AIDS patients in an Asian population

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Abstract

Purpose

This study reports the outcomes of retinal re-attachment surgery in patients with Cytomegalovirus retinitis (CMVR)-related retinal detachment (RD) in an Asian population.

Methods

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

Results

CMVR was inactive in 73.7% of the patients at the time of surgery. Fourteen (73.7%) of RDs were macula-off and 4 (21.1%) patients had proliferative vitreo-retinopathy (PVR). Anatomical success was achieved in 14 patients (73.6%). Eight patients (42.1.%) had improvement of 1 or more lines in BCVA, 7 patients (36.8%) maintained BCVA and 4 patients (21.1%) had poorer BCVA at 6 months after surgery. Of the 13 patients who presented with worse than 6/120 vision, 30.8% regained ambulatory vision or better. Five patients had re-detachments (26.3%). Six phakic patients (54.5%) developed cataracts post-surgery at a median interval of 6 months. Seven patients had immune recovery uveitis (IRU) prior to RD. Median durations from CMVR and IRU diagnoses to RD were 2.0 and 1.0 months respectively.

Conclusion

Surgery for CMVR-related RD is associated with good anatomical outcomes with most patients maintaining or improving vision. Factors related to better outcomes include smaller CMVR lesion size and the absence of PVR. CD4 counts were not related outcomes. Patients diagnosed with CMVR and IRU require close monitoring for development of RD.

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