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J. Diaz-Rubio, A. Lorenzo, V. Kon, M. Torres, E. Oregon, P. Navarro, L. Arellanes, J. Jimenez, V. Morales, H. Quiroz-Mercado; Retinal Detachment After Viral Retinal Necrosis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2111.
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To determine the etiology of retinal detachment, and to evaluate the results of laser photocoagulation, surgical procedure and visual outcome in the treatment of retinal detachment secondary of viral retinitis at our Hospital.
We retrospectively reviewed the cases with diagnosis of viral retinitis in the Retina and Uveitis departments.
We retrospectively reviewed 84 eyes with diagnosis of viral retinis. Etiology was NRA in 33 eyes, PORN in 7 eyes and CMV in 44 eyes. PORN group had the highest rate of detachment and CMV the lowest. 14 eyes were treated with prophylactic laser. Each lesion was completely surrounded with a double or triple row of laser spots. We observed 35% of retinal detachment in eyes with prophylactic laser and in 27% in eyes without prophylactic laser. Vitrectomy and silicone oil tamponade were performed on 11 cases. Scleral buckling was performed on 3 eyes. Retinal detachment was observed in 62% of eyes without scleral buckling; and 33% of eyes that underwent this procedure. Despite the anatomical success of surgery, the visual outcome was not encouraging, with only 20% of eyes achieving a final visual acuity of 20/200 or better. Mean follow-up period was 7+/- 12 months.
Cytomegalovirus retinitis is the most frecuent etiology of viral retinitis in our hospital. Prophylactic laser photocoagulation does not seem to reduce the rate of retinal detachment in our patients. Vitrectomy and scleral buckling could be a treatment option as the initial surgical procedure. Poor visual acuity must be due to optic atrophy and macular scar.
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