Document 0646
 DOCN  M9440646
 TI    A masked prospective evaluation of outcome parameters for
       cytomegalovirus-related retinal detachment surgery in patients with
       acquired immune deficiency syndrome.
 DT    9404
 AU    Kuppermann BD; Flores-Aguilar M; Quiceno JI; Capparelli EV; Levi L;
       Munguia D; Freeman WR; Department of Ophthalmology, University of
       California, San Diego,; La Jolla 92093-0946.
 SO    Ophthalmology. 1994 Jan;101(1):46-55. Unique Identifier : AIDSLINE
       MED/94134393
 AB    PURPOSE: The management of cytomegalovirus (CMV)-related rhegmatogenous
       retinal detachments in patients with acquired immune deficiency syndrome
       (AIDS) has been the subject of recent attention and controversy because
       of the high degree of variability in visual outcome, as well as
       significant differences in the reported incidence of profound
       postoperative optic atrophy. This study was designed to evaluate the
       various parameters affecting postoperative visual outcome, and to
       quantitate the degree of postoperative optic disc pallor. METHODS: The
       results of 65 consecutive surgeries for CMV-related retinal detachments
       in 51 patients with AIDS were prospectively studied. Postoperative
       vision, survival, optic disc pallor, and retinitis extent were analyzed.
       Serial photographs of optic discs underwent masked evaluation. RESULTS:
       Mean postoperative survival was 30 weeks (range, 2-146 weeks). Mean best
       postoperative visual acuity was 20/66 (range, 20/20-2/200) and mean
       final postoperative visual acuity was 20/100 (range, 20/25-no light
       perception). Analysis of visual outcome for eyes with no macular or
       papillo-macular retinitis showed a best postoperative visual acuity of
       20/60 (range, 20/25-2/200) and mean final postoperative visual acuity of
       20/80 (range, 20/25-no light perception). Postoperative vision was not
       affected by the presence of a preoperative macular detachment, with both
       groups (macula on or off detachments), achieving a best postoperative
       visual acuity of 20/60 in the absence of macular retinitis. Mild
       postoperative optic disc pallor was observed in 30% of surgical eyes at
       the final postoperative visit, and moderate pallor was noted in 13%. The
       mean degree of optic disc pallor was not different from the degree of
       optic disc pallor seen in fellow, nonsurgical eyes with CMV retinitis
       (surgical versus fellow nonsurgical eyes, 29% +/- 23% versus 26% +/-
       30%; P = 0.64). CONCLUSION: In this largest reported series of
       reattachment surgery for CMV-related retinal detachments, patients are
       experiencing increased postoperative survival, good vision, and relative
       optic nerve health.
 DE    Adult  AIDS-Related Opportunistic Infections/*COMPLICATIONS/PATHOLOGY
       Cytomegalovirus Retinitis/*COMPLICATIONS/PATHOLOGY  Evaluation Studies
       Follow-Up Studies  Human  Incidence  Middle Age  Optic Disk/PATHOLOGY
       Prospective Studies  Retinal Detachment/ETIOLOGY/PATHOLOGY/*SURGERY
       Support, Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.  Survival Rate
       Treatment Outcome  Visual Acuity  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).