Rhegmatogenous retinal detachment in newly diagnosed CMV retinitis

Purpose. To characterize eyes with rhegmatogenous retinal detachment (RRD) found at the time of CMV retinitis (CMVR) diagnosis. Methods. Medical records of patients diagnosed with CMVR from 05/01/93 through 11/01/95 were reviewed. Seven eyes of 7 patients were identified with RRD and newly diagnosed, previously untreated CMVR. Results. Six patients reported symptoms typical of RRD and/or CMVR. All eyes were myopic (spherical equivalent -0.50 to-10.38 D, median -2.38 D). All eyes had CMVR in zones 2 and 3, with variable zone 1 involvement. Extent of CMVR ranged from 10 to 70% retinal involvement. There was a negative correlation between diopters of myopia and extent of CMVR involvement (P=.09). All RRDs were unilateral, with macular involvement in two, the others progressed to involve or threaten the macula. Six eyes underwent pars plana vitrectomy and silicone oil tamponade with successful reattachment. Best postoperative visual acuities ranged from 20/40 to 20/130 (median 20/60). Five eyes demonstrated progressive visual loss due to CMVR and/or cataract. Final postoperative visual acuities ranged from 20/40 to HM (median 20/200). Three of five with bilateral CMVR developed RRD in the fellow eye. Follow-up ranged from 4 to 24 months (median 6 months). Conclusions. RRD may be present at the time of diagnosis of CMVR, especially in myopic eyes. The visual prognosis appears similar to other patients with CMVR and RRD. Higher degrees of myopia may predispose to earlier development of RRD.