Rhegmatogenous retinal detachment in uveitis

Abstract Background Retinal detachment is more common among uveitis patients than in the general population. Here, we aimed to assess the prevalence of rhegmatogenous retinal detachment (RRD) in a uveitis population. Methods We retrospectively studied 851 uveitis patients, recording characteristics such as uveitis duration, anatomical location, and cause; RRD occurrence; proliferative vitreoretinopathy (PVR) at presentation; surgical approach; reattachment rate; and initial and final visual acuity (VA). Results RRD occurred in 26 patients (3.1%; 29 affected eyes) and was significantly associated with posterior uveitis (p < 0.001), infectious uveitis (p < 0.001), and male gender (p = 0.012). Among cases of infectious uveitis, cytomegalovirus and varicella zoster virus were most commonly associated with RRD development. RRD in non-infectious uveitis was not found to be associated with any specific uveitis entity. The rate of single-operation reattachment was 48%, and the rate of final reattachment was 83%. Mean final VA was 20/125, with 41% of eyes ultimately having a VA of less than 20/200. Conclusion Uveitis is a risk factor for RRD development, which carries a poor prognosis

Anatomic and functional outcomes of 25-gauge vitrectomy for repair of eyes with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

Chiharu Iwahashi-Shima, Tatsuhiko Sato, Hajime Bando, Toshihide Ikeda, Kazuyuki EmiOsaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, Sakai, JapanBackground: The purpose of this study was to evaluate the outcome of 25-gauge vitrectomy for repair of rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR).Methods: Twenty-seven eyes of 27 patients who had undergone 25-gauge vitrectomy for grade C PVR were investigated retrospectively. The surgical procedures, anatomic success, and best-corrected visual acuity were assessed.Results: The mean number of operations was 1.4 (range 1&ndash;4). During the 25-gauge vitrectomy, 20-gauge instruments were needed in eleven eyes (40.7%) to remove resilient fibrous preretinal membranes, to extract subretinal proliferations, or to remove or infuse silicone oil. The retina was reattached in 21 eyes (77.8%) after the initial vitrectomy and in 25 eyes (92.6%) at the final examination. The mean best-corrected visual acuity in logarithm of the minimal angle of resolution units was 1.36 &plusmn; 0.81 before vitrectomy and 0.79 &plusmn; 0.71 at one month, 0.73 &plusmn; 0.72 at 3 months, 0.73 &plusmn; 0.75 at 6 months, and 0.75 &plusmn; 0.78 at 12 months after vitrectomy. The best-corrected visual acuities were significantly improved compared with the preoperative ones at all postoperative assessments (P<0.001).Conclusion: Twenty-five gauge vitrectomy is a relatively safe and efficacious method of treating RRD with PVR, although combined use of 20-gauge instruments may be needed for certain surgical procedures.Keywords: proliferative vitreoretinopathy, rhegmatogenous retinal detachment, 25-gauge vitrectomy, hybrid vitrectomy, vitrectom