Visual outcome following repair of retinal detachment with silicone oil in patients with cytomegalovirus retinitis

Purpose. To compare the visual outcome following repair of retinal detachment (RD) with silicone oil among eyes with cytomegalovirus (CMV) retinitis with macula-on versus macula-off retinal detachment (RD) preoperatively. Methods. We retrospectively reviewed 20 cases in our group and 56 cases reported in the literature (Garcia et al., Ophthalmology 102: 236, 1995) with a postoperative follow-up of ≥ 2 mos. The preoperative and best postoperative visual acuity (VA) among patients with macula-on versus macula-off RD were compared. Results. Among 76 cases reviewed (43% macula-on), VA declined ≥ 2 lines after surgery in 64% of eyes with macula-on RD and in 12% of eyes with macula-off RD. The range of best postoperative VA was 20/20 to light perception in the macula-on group and 20/30 to hand motions in the macula-off group. When the VA was converted to decimal form and analyzed, the mean postoperative VA was 20/50 in the macula-on group and 20/70 in the macula-off group. This difference was statistically significant (p < 0.05). Conclusions. Although most eyes with macula-on RD due to CMV retinitis experience some loss of vision following surgery with silicone oil, the mean postoperative VA is better in eyes that have macula-on RD when compared to eyes with macula-off RD preoperatively.