title: Cytomegaloviral retinitis-related retinal detachment: outcomes following vitrectomy in the developing world.
abstract: The purpose of this study is to describe the functional and anatomical outcomes of cytomegaloviral retinitis (CMVR) patients undergoing vitrectomy for retinal detachment (RD) in South Africa. In this retrospective case series, CMVR diagnoses were based on clinical examination alone. All vitrectomies were performed by a single surgeon. Main outcome measures were visual acuity (VA) and retinal re-attachment success rate. Thirty-nine patients (43 eyes) were followed up from the time of RD diagnosis for a mean 19.3 months ± 13.8 (standard deviation). Successful anatomical re-attachment was achieved in 38 (88 %) eyes. Silicone oil was used as initial tamponade in 39 eyes, with C3F8 being used in the remaining four (9 %) eyes with ≤2 small retinal breaks. The presence of high-grade proliferative vitreoretinopathy (n = 11 eyes, 26 %) was not associated with a greater risk of re-detachment (p = 0.24, Fisher's exact test). Functional outcomes were limited, with an overall rate of legal blindness (≤6/60) from the time of RD diagnosis of 0.58/eye year. Final VA strongly correlated with VA at the time of RD diagnosis (p = 0.018, paired t test). Two eyes (5 %) lost perception of light during the study period. Severe visual impairment is likely following CMVR-related RD in a developing world healthcare setting, despite successful anatomical re-attachment in most cases.
authors.affiliation: Department of Ophthalmology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, 4013, South Africa, srigore@gmail.com.
authors.forename: Sri K
authors.initials: SK
authors.lastname: Gore
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Gore
authors.forename: Kreasen
authors.initials: K
authors.lastname: Chetty
authors.forename: Linda
authors.initials: L
authors.lastname: Visser
mesh_terms: D000328:Adult; D017726:Cytomegalovirus Retinitis / Q000150:complications*; D003906:Developing Countries; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013019:South Africa; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy