25-gauge PPV for acute retinal necrosis-related RRD yields good anatomical outcomes

Investigators report the anatomic and functional outcomes of 25-guage pars plana vitrectomy (PPV) for acute retinal necrosis (ARN)-related rhegmatogenous retinal detachment (RRD).

Study design

In this single-center retrospective case series, 14 eyes underwent PPV with encircling scleral band during a 4-year period. Retinal detachment occurred between 1 to 14 weeks after the onset of ocular symptoms. Three eyes had active retinitis with RRD and 11 had RRD with healed retinitis and atrophic retina.

Complete anatomic success was defined as attachment of the macula and peripheral retina. Functional success was defined as final BCVA of 20/400 or higher at the last follow-up.

Outcomes

There were no intraoperative complications. After surgery, all eyes achieved complete anatomical success and 6 eyes achieved functional success. Nine patients experienced improvement in vision and 4 maintained preoperative vision. One eye developed phthisis bulbi after silicone oil removal. The authors note that all study eyes had some level of optic disc pallor.

Limitations

This study is limited by its study design: it is a retrospective study with a small sample size and was conducted at a single center.

Clinical significance

These findings show that 25-gauge PPV can yield anatomical advantages when treating patients with ARN‑related RRD compared with scleral buckle surgery and 20-gauge PPV. However, the presence of ischemic optic atrophy and active retinitis along with RRD may be considered a poor prognostic factor for functional outcomes.