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M.–H. Errera, N. Cassoux, B. Dupas, B. Bodaghi, F. Le Hoang, M. De Smet; Retinal Detachment and Uveitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4223.
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This study aimed to evaluate surgery of retinal detachment secondary to uveitis. In particular were analysed the etiologies of uveitis leading to retinal detachment, the surgical techniques employed and .postoperative visual acuity.
Retrospective case–controle study. The study consisted of 33 patients (38 eyes) treated for retinal detachments associated with uveitis. Different etiologies of uveitis were found : virological diagnosis was made in 62% of them, varicelle zoster virus was found in 10% of them, herpex simplex virus in 18%, cytomegalovirus in 34%. Retinal detachment was also identified with infectious uveitis (17%) and with non infectious uveitis (21%). Surgical management of retinal detachment was performed by ab–externo surgical techniques or by vitreous surgery
The main outcome measures are the rate of second eye involvement, delay between the onset of uveitis symptoms and retinal detachment, anatomic location of uveitis and its inflammatory activity. Anatomic outcomes were the extent of retinal detachment and the presence of PVR, complete retinal attachment or recidive. Visual acuity outcomes were studied compared to preoperative visual acuity. Complications were : rates of secondary intraocular pressure elevation, hypotony, cataract and ocular phtysis, occurrence of postoperative reproliferation. Rhegmatogenous retinal detachment is associated with viral uveitis in 62% of cases and is a serious complication of acute retinal necrosis. At the onset of retinal detachment uveitis was active in 75 % of the affected eyes. Proliferative vitreoretinopathy was present in 24% of the eyes. The final anatomic reattachment rate was 81% and after a single operation 79% of the retinas were reattached. The postoperative visual acuity was studied with incidence of visual loss to the level of 20/200 or worse at 62%.
Retinal detachment is a very serious complication of uveitis. Retinal detachment was achieved in the majority of the eyes using vitrectomy and silicone oil retinal tamponade and/or scleral buckling and/or retinotomies. We noted a high rate of retinectomies (7) associated with viral uveitis. We obtained a good anatomic outcomes but even with antiviral therapy the visual prognosis of retinal detachment in uveitis remains poor . The reason is certainly because of the high rate of viral retinis leading to extensive necrosis and important retinal detachment complicated of PVR.
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