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

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 9; no. default; pp. 1307 - 1314
• Main Authors: Almeida, David Rp, Chin, Eric K, Tarantola, Ryan M, Tegins, Elizabeth O, Lopez, Christopher A, Boldt, Herbert Culver, Gehrs, Karen M, Sohn, Elliott H, Russell, Stephen R, Folk, James C, Mahajan, Vinit B
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2015; Taylor & Francis Ltd; Dove Press; Dove Medical Press
• Subjects: acute retinal necrosis; Care and treatment; Chicken pox; Complications and side effects; Cytomegalovirus; Detachment; Development and progression; Eyes; Fasteners; Herpes simplex virus; Herpes viruses; herpetic retinitis; Males; Nerves; Ophthalmology; Original Research; Patient outcomes; Patients; Placement; Retina; Retinal detachment; Standard deviation; Varicella-zoster virus; viral retinitis; Virus diseases; Visual acuity; Vitrectomy; herpetic retinitis; viral retinitis; vitrectomy; acute retinal necrosis; retinal detachment
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S87644

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