title: Retinal detachment in patients with acquired immunodeficiency syndrome.
abstract: Cytomegalovirus retinopathy is the most frequent opportunistic infection of the eye in patients with acquired immunodeficiency syndrome (AIDS). We studied 71 patients with cytomegalovirus retinopathy (n = 69) or acute retinal necrosis (n = 2) with respect to the frequency and management of retinal detachment. Retinal detachment was seen in 14 patients (relative frequency, 19.7%). In 2 patients, the retinal detachment was bilateral. In 5 patients, pars plana vitrectomy and silicone-oil tamponade was performed, and in 1 of these patients scleral buckling was applied before vitrectomy. In 3 other patients scleral buckling was performed, and 1 of these individuals had sulfur-hexafluoride injection. In 8 eyes (6 patients), retinal detachment occurred in eyes with completely burned-out retinopathy without relevant function, and no surgical treatment was performed. Long-term retinal reattachment was seen in all 5 patients undergoing pars plana vitrectomy with silicone-oil tamponade. Visual acuity was preserved until the last follow-up in 4 of these 5 patients. In the patients undergoing a buckling procedure alone, no anatomic or functional success was observed. During vitrectomy, reduced retinal vascular perfusion and blood-flow sludging was observed in 2 patients. As the duration of survival of patients with AIDS and cytomegalovirus retinopathy or acute retinal necrosis is increasing, more cases of retinal detachment will be observed. Overall, 5% of patients with AIDS are expected to develop retinal detachment. In conclusion, treatment of cytomegalovirus-associated retinal detachment by pars plana vitrectomy with silicone-oil tamponade seems to be successful and safe and may maintain the patient's quality of life.
authors.affiliation: Universitäts-Augenklinik, München, Germany.
authors.forename: S A
authors.initials: SA
authors.lastname: Geier
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: J R
authors.initials: JR
authors.lastname: Bogner
authors.forename: H
authors.initials: H
authors.lastname: Schmidt-Kittler
authors.forename: I
authors.initials: I
authors.lastname: Sadri
authors.forename: F D
authors.initials: FD
authors.lastname: Goebel
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000188:drug therapy; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000188:drug therapy; D005500:Follow-Up Studies; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery; D015882:Retinal Necrosis Syndrome, Acute / Q000150:complications / Q000188:drug therapy; D014792:Visual Acuity
chemical_list: D017245:Foscarnet; D015774:Ganciclovir; D000212:Acyclovir