Primary Rhegmatogenous Retinal Detachment Repair by Pars Plana Vitrectomy With and Without Scleral Buckling: A Propensity Score Analysis [Response to Letter]

Pongthep Rajsirisongsri,1 Direk Patikulsila,1 Phichayut Phinyo,2–4 Paradee Kunavisarut,1 Voraporn Chaikitmongkol,1 Onnisa Nanegrungsunk,1 Atitaya Apivatthakakul,1 Sutheerada Seetasut,1 Yaowaret Tantivit,1 Napatsorn Krisanuruks,1 Apisara Sangkaew,1 Nawat Watanachai,5 Janejit Choovuthayakorn1 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Biomedical Informatics and Clinical Epidemiology (Bioce), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand; 5Department of Ophthalmology, Faculty of Medicine, Mahidol University, Bangkok, ThailandCorrespondence: Janejit Choovuthayakorn, Email [email protected]

Contralateral Eye Involvement and Retinal Detachment in Patients with Cytomegalovirus Retinitis Treated with Intravitreous Ganciclovir

Purpose: To determine the incidence of contralateral eye involvement and retinal detachment in HIV-infected patients with cytomegalovirus retinitis treated with repeated intravitreous ganciclovir. Methods: In a prospective cohort study in Northern Thailand, HIV-infected patients with cytomegalovirus retinitis were treated with antiretroviral therapy and intravitreous ganciclovir injections and followed for 3 months for contralateral cytomegalovirus retinitis and retinal detachment. Results: Of 49 participants with unilateral cytomegalovirus retinitis at enrollment, 7 developed contralateral eye involvement (4.8/100 person-months, 95% CI 1.9–9.8). Of 105 eyes without a retinal detachment at enrollment, 6 developed a retinal detachment (2.0/100 eye-months, 95% CI 0.7–4.3). Baseline clinical factors were not associated with the development of either outcome. Conclusion: Eyes treated with intravitreous ganciclovir experienced retinal detachment at a rate similar to other populations treated with systemic antivirals. The risk of contralateral eye involvement was relatively high during the first 3 months after initial diagnosis despite the institution of antiretroviral therapy.</p