Abstract
Patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus retinitis (CMVR) are surviving longer due to the use of virostatic medicines and improved treatment of opportunistic infections. As a result, retinal detachment is likely to become an increasingly common cause of visual morbidity in these patients. The incidence and outcome of retinal detachment complicating CMVR was studied at two London AIDS centres. Patients with CMVR were identified prospectively and underwent standard treatment. Retinal detachments were diagnosed during regular follow-up. if retinal reattachment surgery was performed, a standard procedure of vitrectomy and silicone oil internal tamponade was employed. Of 147 patients with CMVR, 41 (28%) developed retinal detachments (47 eyes). Forty-three detachments were rhegmatogenous and 4 were exudative. Fifteen eyes of 9 patients with rhegmatogenous detachments underwent retinal reattachment surgery. Of these, visual acuity remained stable or improved in 12 eyes (80%) in the immediate post-operative period. At the last clinic visit, 8 eyes (53%) maintained a visual acuity of 6/60 or better. The visual results of surgery are good in selected patients, bearing in mind the progressive nature of the underlying disease and poor life expectancy.
Similar content being viewed by others
Article PDF
References
Holland GN, Gottleib MS, Yee RD, Schanker HM, Pettit TH . Ocular disorders associated with a new severe acquired cellular immunodeficiency syndrome. Am J Ophthalmol 1982;93:393–402.
Orellana J, Teich SA, Leiberman RM, et al Treatment of retinal detachments in patient with the AIDS. Ophthalmology 1991;98:939–43.
Sidikaro Y, Silver L, Holland GN, Kreiger AE . Rhegmatogenous retinal detachments in patients with AIDS and necrotizing retinal infections. Ophthalmology 1991;98:129–35.
Freeman WR, Henderly DE, Wan WL, et al. Prevalence, pathophysiology and treatment of rhegmatogenous retinal detachment in treated cytomegalovirus retinitis. Am J Ophthalmol 1987;107:527–36.
Broughton WL, Cupples HP, Parver LM . Bilateral retinal detachments following cytomegalovirus retinitis. Arch Ophthalmol 1978;96:618–9.
Meredith TA, Aaberg TM, Reeser FH . Rhegmatogenous retinal detachment complicating cytomegalovirus retinitis. Am J Ophthalmol 1979;87:793–6.
Friedman AH, Orellana J, Freidman WR, et al. Cytomegalovirus retinitis: a manifestation of the acquired immune deficiency syndrome. Br J Ophthalmol 1983;67:372–80.
Palestine AG, Rodrigues MM, Macher AM, Chan C, et al. Ophthalmic involvement in AIDS. Ophthalmology 1984;91:1092–99.
D'Amico DJ, Talamo JH, Felsenstein D, et al. Ophthalmoscopic and histologic findings in cytomegalovirus retinitis treated with BW-B759U. Arch Ophthalmol 1986;104:1788–93.
Holland GN, Sidikaro Y, Kreiger AE, et al. Treatment of CMV retinopathy with ganciclovir. Ophthalmology 1987;94:815–23.
Jabs DA, Enger C, Haller J, de Bustros S . Retinal detachments in patients with cytomegalovirus retinitis. Arch Ophthalmol 1991;109:794–9.
Holland GN, Sakamoto MJ, Hardy D, et al. Treatment of cytomegalovirus retinopathy in patient with acquired immune deficiency syndrome: use of the experimental drug 9-[2-hydroxy-1-(hydroxymethyl)-ethoxymethyl]guanine. Arch Ophthalmol 1986;104:1794–800.
Jabs DA, Enger C, Bartlett JG . Cytomegalovirus retinitis and acquired immunodeficiency syndrome. Arch Ophthalmol 1989;107:75–80.
Gross JG, Bozzette SA, Mathews WC, Spector SA, Abramson IS, McCutchan JA, Mendez T, Munguia T, Freeman WR . Longitudinal study of CMV retinitis in AIDS. Ophthalmology 1990;97:681–6.
Holland GN, Buhles WC, Mastre B, et al. A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy: use of a standardised system for the assessment of disease outcome. Arch Ophthalmol 1989;107:1759–66.
Teich SA, Orellana J, Freidman AH . Prevalence, pathophysiology and treatment of rhegmatogenous retinal detachment in treated cytomegalovirus retinitis [letter]. Am J Ophthalmol 1987;104:312–3.
Freeman WR, Quicenco JI, Crapotta JA, et al. Surgical repair of rhegmatogenous retinal detachment in immunosuppressed patients with cytomegalovirus retinitis. Ophthalmology 1992;99:466–74.
Holland GN . The management of retinal detachments in patients with the acquired immune deficiency syndrome [editorial]. Arch Ophthalmol 1991;109:791–3.
Henry K, Cantrill HL, Fletcher C, et al Use of intravitreal ganciclovir (dihydroxypropoxymethylguanine) for cytomegalovirus retinitis in a patient with AIDS. Am J Ophthalmol 1987;107:17–23.
Ussery FM, Gibson SR, Conklin RH, et al. Intravitreal ganciclovir in the treatment of AIDS associated CMV retinitis. Ophthalmology 1988;95:640–8.
Cantrill HL, Henry K, Melroe H, et al. Treatment of cytomegalovirus retinitis with intravitreal ganciclovir: long term results. Ophthalmology 1989;107:367–74.
Heinemann MH . Long-term intravitreal ganciclovir for cytomegalovirus retinopathy. Arch Ophthalmol 1989;107:1767–72.
Cochereau-Massin I, LeHoang P, Lautier-Frau M, et al. Efficacy and tolerance of intravitreal ganciclovir in cytomegalovirus retinitis in acquired immune deficiency syndrome. Ophthalmology 1991;98:1348–55.
Dugel PU, Liggett PE, Lee MB, et al. Repair of retinal detachment caused by cytomegalovirus retinitis in patients with the acquired immune deficiency syndrome. Am J Ophthalmol 1991;112:235–42.
Federman JL, Schubert HD . Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. Ophthalmology 198;95:870–6.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sandy, C., Bloom, P., Graham, E. et al. Retinal detachment in AIDS-related cytomegalovirus retinitis. Eye 9, 277–281 (1995). https://doi.org/10.1038/eye.1995.54
Issue Date:
DOI: https://doi.org/10.1038/eye.1995.54
Keywords
This article is cited by
-
Infectious Uveitis
Current Ophthalmology Reports (2015)
-
Results of silicone oil removal in post-cytomegalovirus retinitis-related retinal detachment
Journal of Ophthalmic Inflammation and Infection (2012)