Junctional proliferative vitreoretinopathy in rhegmatogenous retinal detachment secondary to viral retinitis in HIV.

Abstract

Introduction: Rhegmatogenous retinal detachment (RRD) is a vision-threatening complication of viral retinitis, at times compounded by proliferative vitreoretinopathy (PVR) at the junction of the necrotic and unaffected retina.

Methods: Retrospective review of eyes with 'junctional PVR' in RRD after viral retinitis. We define junctional PVR as presence of stiffness, transverse traction, epiretinal membrane and/or pucker at the junction of normal and necrotic retina.

Results: Five eyes of four patients with a mean age at presentation of 46.5 ± 10.96 years were included. Immunosuppression due to Human immunodeficiency virus (HIV) was the underlying condition in all the cases. Posterior hyaloid removal and epiretinal membrane removal at the junctional PVR was performed in all cases. Favourable outcomes were observed in seven sites where epiretinal membrane (ERM) removal with inner limiting membrane (ILM) peeling was performed; however, one site developed localised RRD requiring re-surgery. The mean logMAR best-corrected visual acuity (BCVA) improved from 1.84 before surgery to 0.64 during the last follow-up. All patients had undergone 23 G vitrectomy and silicone oil tamponade 1500 Centistokes (cSt) was used in all patients for a mean duration of 6.8 months.

Conclusion: Management of posterior hyaloid coupled with ERM removal and localised ILM peeling may be used to address junctional PVR in the eyes with RRD after viral retinitis.