Outcomes of 25-gauge pars plana vitrectomy for cytomegalovirus retinitis-related retinal detachment

• Published in: Indian journal of ophthalmology 2021-09, Vol.69 (9), p.2361-2366
• Main Authors: Moharana, Bruttendu, Dogra, Mohit, Tigari, Basavaraj, Singh, Simar, Katoch, Deeksha, Arora, Atul, Singh, Ramandeep
• Format: Article
• Language: English
• Subjects: 25-gauge vitrectomy; Acuity; Care and treatment; cmv; Complications; Complications and side effects; Cytomegalovirus; Cytomegalovirus infections; Cytomegalovirus Retinitis - complications; Cytomegalovirus Retinitis - diagnosis; Dyskeratosis; Eye; HIV; Human immunodeficiency virus; Humans; Macula Lutea; Malignancy; Original; pars plana vitrectomy; Patient outcomes; Patients; Postoperative; Retina; Retinal detachment; Retinal Detachment - diagnosis; Retinal Detachment - surgery; Retinal diseases; Retinitis; Retrospective Studies; Silicones; Statistical analysis; Success; Tamponade; Visual Acuity; Vitrectomy
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_3539_20

Purpose: The purpose of this study is to evaluate the anatomical and functional outcomes of 25-gauge (G) pars plana vitrectomy (PPV) in patients with cytomegalovirus retinitis (CMVR)-related rhegmatogenous retinal detachment (RRD). Methods: Single-center retrospective consecutive case series of patients who underwent 25-G PPV for CMVR-related RRD repair with a minimum follow-up of 3 months. Complete anatomic success was defined as the complete attachment of retina including the periphery. Best-corrected visual acuity (BCVA) of ≥20/400 was defined as functional success. Results: Sixteen eyes of 15 patients were included in the study. Eleven patients were human immunodeficiency virus positive, three patients had hematological malignancies, and one patient suffered from dyskeratosis congenita. The mean follow-up was 20.5 ± 17.4 months (range 3-60 months). Complete anatomical success was seen in 15 eyes (93.75%). One eye had a residual inferior detachment with attached macula. Silicone oil was used as tamponade in 15 eyes and C3F8 gas in one eye. The mean change in BCVA was statistically significant, preoperative LogMAR BCVA was 2.05 ± 0.94 while the final follow-up postoperative LogMAR BCVA was 1.03 ± 0.61 (P < 0.001). Thirteen eyes (81.25%) had final BCVA ≥20/400. Conclusion: Microincision vitrectomy surgery can achieve excellent retinal reattachment rates in post-CMVR RRDs without significant intraoperative and postoperative complications. The visual outcome varies depending on the status of the optic disc and macula. Majority of the patients maintained functional vision.