Surgical repair of retinal detachment secondary to cytomegalovirus retinitis

BACKGROUND AND OBJECTIVE: This study was conducted to determine preoperativ e predictors of postoperative visual acuity in patients with acquired immun odeficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis and retinal detachment. PATIENTS AND METHODS: The study design was a retrospective chart review of 38 eyes in 33 patients with AIDS and CMV retinitis who had retinal reattach ment surgery by pars plana vitrectomy with the use of silicone oil tamponad e. Factors considered included: preoperative visual acuity, macular attachm ent status and CMV activity at the time of surgery, and length of time from diagnosis of retinal detachment to surgical repair. RESULTS: Retinal reattachment was achieved in 37 of 38 eyes. Mean interval from surgery to best corrected visual acuity (VA) was 3 weeks. The mean bes t corrected post-op VA was 20/70. Approximately half of the patients died w ithin 7 months of the surgery. There was good correlation between preoperat ive VA and best attained postoperative VA (Spearman's: r = 0.5139, P = 0.00 1). The interval from retinal detachment to surgery, and best attained post operative VA did not correlate (Spearman's: r = 0.2333,.P = 0.158). The lac k of macular CMV retinitis correlated well with postoperative VA (P = 0.000 66, Wilcoxon rank-sum test). CONCLUSIONS: Preoperative visual acuity and macular attachment status corre lates with better postoperative visual acuity results, whereas early surgic al repair of retinal detachment does not.