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Francisco Virmond Moreira, Andressa Moreira Iwanusk, Augusto Amaral, Mario J Nobrega, Fernando De Novelli; Surgical outcomes of rhegmatogenous retinal detachments associated with ocular toxoplasmosis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5097.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomic and functional outcomes after treatment of rhegmatogenous retinal detachment secondary to ocular toxoplasmosis in an area with high prevalence of the infection.
Retrospective, non-comparative, consecutive case series of patients with retinal detachment secondary to ocular toxoplasmosis and operated from April 2000 to February 2013. Initial surgery consisted of scleral buckle (SB) or pars plana vitrectomy (PPV) or combined SB and PPV. Gas or silicone oil tamponade were used in cases of PPV. Anatomic retinal status, visual acuity and postoperative complications were analyzed.
Twenty-three eyes of 23 patients were treated. Thirteen patients (56.5%) were women and the mean age was 29.1 years-old (range 12-78 yo). Mean follow-up (f/u) period was 58.2 months (range 1-161 months). Mean preoperative best-corrected visual acuity (BCVA) was 2.0 logMAR (20/2000 on the Snellen scale). At last f/u visit, retina was reattached in 21 eyes (91.3%). Fifteen eyes (65.2%) required one surgery and 8 eyes (34.8%) required 2 surgeries. Initial surgery was SB in 3 eyes (13.0%), PPV in 6 eyes (26.1%) and SB plus PPV in 14 eyes (60.1%). Gas endotamponade was first used in 5 eyes (21.7%) and silicone oil was used in 15 eyes (65.2%). Silicone endotamponade was used in all of the 8 reoperated eyes. BCVA improved in 15 eyes (65.2%), stabilized in 6 eyes (26.1%) and decreased in 2 eyes (8.7%) (Fig. 1). Mean postoperative BCVA was 1.2 logMAR (20/317). Nineteen eyes (82.6%) required an additional cataract surgery while 5 eyes (21.7%) developed glaucoma and 1 eye (4.3%) developed hypotonia.
Surgical treatment of retinal detachment secondary to ocular toxoplasmosis provided favorable anatomic and functional outcomes in the majority of cases. Otherwise, cataract surgery was frequently necessary and long-term complications, such as glaucoma and hypotonia, occurred in ¼ of the treated eyes.
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