Risk Factors for Development of Rhegmatogenous Retinal Detachment in Patients with Cytomegalovirus Retinitis

Freeman, William R.; Friedberg, Dorothy N.; Berry, Charles C.; Quiceno, José I.; Behette, Marguerite; Fullerton, S; Munguia, David

doi:10.1016/s0002-9394(14)73471-3

Cited by 101 publications

(37 citation statements)

References 16 publications

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“…This rate appears very low compared to overall detachment rates found by other investigators of 11-26% [12,13]. Freeman et al [14] found that the risk of retinal detachments increases if more than 25% of the peripheral retina is destroyed. The long-term treatment regimen positively influenced the detachment rate in our series, possibly indicating that in affected eyes more retina could be preserved than in comparable groups.…”

Section: Discussionmentioning

confidence: 75%

Evaluation of Cytomegalovirus Retinitis Management

Ries¹,

Mühlbauer

Ruhswurm³

et al. 1998

Ophthalmologica

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Cytomegalovirus (CMV) is the most common pathogen of opportunistic viral infections in patients with the acquired immunodeficiency syndrome. In this study, we assessed the therapeutic outcome of our treatment regimen of CMV retinitis by analysing retrospectively 33 consecutive patients. The clinical utility of CMV cultures from blood, urine and throat specimens obtained at the time of diagnosis was additionally evaluated. Treatment started with ganciclovir (GCV) therapy. In case of relapsing retinitis, re-induction therapy was initiated, and if unsuccessful, the patient was switched to foscarnet. Patients developing resistant retinitis despite foscarnet therapy were offered a GCV-foscarnet combination therapy. Under primary GCV therapy, the median first stable interval of the whole group was 202 days (mean 238 days). Twenty-five out of 33 CMV retinitis patients (76%) responded to initial GCV therapy. Eleven of these patients showed relapsing retinitis that could be stabilised in 3 patients solely with combination therapy. Eight patients did not respond to primary GCV therapy. Three of them improved with foscarnet, but 3 patients did not respond to either treatment. In 18 (56%) out of 32 patients, CMV cultures yielded positive results. Considering our series, we may conclude that in the majority of patients primary or secondary viral resistance can be overcome by dose increase, switching to the alternative drug or a combination therapy.

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Section: Discussionmentioning

confidence: 75%

Evaluation of Cytomegalovirus Retinitis Management

Ries¹,

Mühlbauer

Ruhswurm³

et al. 1998

Ophthalmologica

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“…AIDS patients are at high risk of blindness since the contralateral eye may experience retinal necrosis of the posterior pole, optic atrophy or rhegmatogenous retinal detachment in 46-67% of cases.15, 16 The incidence of retinal detachment in viral retinitis is related to the involvement of pre-equatorial retina2 and to the extent2,16 and duration of retinitis. It occurs over active15-17 or healed4 retinitis.…”

Section: Discussionmentioning

confidence: 99%

Management of viral retinitis-associated retinal detachment in AIDS

Hannouche

Korobelnik

Cochereau

et al. 1997

Eye

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SUMMARYWe retrospectively reviewed the results of surgery in 27 Cytomegalovirus (CMV) and varicella zoster virus (VZV) retinitis are the two most common ocular manifestations in acquired immune deficiency syn drome (AIDS). Rhegmatogenous retinal detachment occurs in 17_34%1,2 and 70%3 of the involved eyes, respectively. Its incidence is increasing owing to the extension of patients' life expectancy. Preservation of visual function in these eyes requires control of the retinitis using active antiviral medication and man agement of the related retinal detachment.Extraocular explantation has failed to cure these rhegmatogenous retinal detachments,2, 4 ,5 which are related to small, multiple breaks, often posteriorly located, at the margins of or over the inactive retinitis. Laser photocoagulation around the detached area does not prevent the progression of subretinal fluid.6 Recurrent detachments have been From:

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“…Der resultierende Visusverlust entspricht einerseits den so entstehenden Skotomen, andererseits kommt es in den atrophen Narbenarealen haufig zu Netzhautdefekten and konsekutiven Netzhautabhebungen. Die Wahrscheinlichkeit solcher Ablationes liegt bei 20 bis 26% [17,21,27]. Das Risiko einer Abhebung steigt bei Augen, die ausgedehnte, periphere CMV-Narben aufweisen [17].…”

Section: Pathophysiologieunclassified

“…Die Wahrscheinlichkeit solcher Ablationes liegt bei 20 bis 26% [17,21,27]. Das Risiko einer Abhebung steigt bei Augen, die ausgedehnte, periphere CMV-Narben aufweisen [17]. Die schwerwiegendsten Visusverluste erleiden Patienten heute Burch sekundare Netzhautabhebungen, im Gegensatz zu den davorliegenden Jahren, in denen die nicht beherrschbare Retinitis Bas Hauptproblem darstellte.…”

Section: Pathophysiologieunclassified