PROGNOSIS OF RETINAL-DETACHMENT IN CMV RE TINITIS

Purpose To evaluate the incidence and the prognosis of retinal detachm ent in CMV retinitis in AIDS. To test intravitreal injections of ganci clovir into the vitreal cavity filled with silicone. Methods Among 136 eyes with CMV retinitis, 15 (11 %) had retinal detachment. Ten eyes u nderwent intraocular surgery with injection of silicone oil, one extra ocular surgery and four eyes were not operated. Later four eyes filled with silicone received intravitreal injections of ganciclovir. Result s At 2 months, the retina was flat in all the operated eyes, with a vi sual acuity improved or stabilized in 8 cases (73 %). Conversely, visu al acuity tvas lost in all the unoperated eyes. The 14 intravitreal in jections of ganciclovir performed in four eyes (which received 2, 3, 3 or 6 injections, respectively) were well tolerated. Conclusion Surger y of retinal detachment in CMV retinitis usually allows the conservati on of ambulatory visual acuity. Its indications must be discussed toge ther with the patient, the ophthalmologist and the physician. Intravit real injections of ganciclovir in vitreal cavity filled with silicone oil are possible.