ABSTRACT
A series of nine eyes of five patients at LRBT Tertiary Teaching Eye Hospital, from July 2020 to June 2021 is reported. Five patients with high clinical suspicion of CMV Retinitis were treated with weekly intravitreal injections of 2.0 mg ganciclovir for 3 weeks. Pre- and post-injection visual acuity and clinical findings were noted. After 3 injections, clinical signs of CMV retinitis started to resolve in all eyes (100%). Visual acuity improved in seven eyes (77.7%) and remained stable in two eyes (22.2%). Two of the seven eyes which initially showed improvement, later on developed retinal detachment. Patients were followed up for a minimum duration of 1 year. Intravitreal ganciclovir is effective for CMV retinitis but follow- up for a longer duration is needed as these patients are prone to develop peripheral retinal tractions and detachments. Key Words: Ganciclovir, CMV retinitis, AIDS.
Subject(s)
Acquired Immunodeficiency Syndrome , Cytomegalovirus Retinitis , Humans , Cytomegalovirus Retinitis/drug therapy , Ganciclovir/therapeutic useABSTRACT
Objectives: Chorioretinal diseases requiring the use of anti-vascular endothelial growth (anti-VEGF) injections often occur in both eyes simultaneously. This can necessitate injecting both eyes together rather than one eye at a time. The purpose of the study was to determine whether simultaneous bilateral intravitreal injections of anti-VEGF agents are safe when administered in an operation theatre setting. Methods: Retrospective review of data was conducted. Single center study conducted in a tertiary care hospital in Karachi Pakistan. Approximately 30,000 eyes that received anti-VEGF injection during a 10-year study period were included (March 2008-February 2018). Patients who were lost to follow up prior to completion of treatment were excluded. Consecutive sampling technique was employed. The patients who received bilateral anti-VEGF injections were analysed separately from the ones who received unilateral injections. All injections were administered in operating theatre setting. The rate of endophthalmitis was measured in each group. Results: A total of 30,258 injections were administered of which 15,338 were bilateral injections. Four cases (4/30,258, 0.013%) of endophthalmitis occurred during the study period. Only one case (1/15,338, 0.0065%) of endophthalmitis occurred after the administration of simultaneous bilateral anti-VEGF injections. Conclusions: Administration of simultaneous bilateral anti-VEGF injections was safe in our population.
ABSTRACT
OBJECTIVE: To determine the outcomes of using perfluorocarbon liquid (PFCL) as postoperative tamponade in complex inferior retinal detachments. STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: Layton Rahmatullah Benevolent Trust (LRBT) Eye Hospital, Karachi, Pakistan, from January 2020 to December 2021. METHODOLOGY: This study was carried out on forty eyes of forty patients from the surgical retina clinic with rhegmatogenous inferior retinal detachment involving macula having proliferative vitreoretinopathy grade C (PVR grade-C). All eyes underwent 25G pars plana vitrectomy with PFCL as postoperative tamponade for 15 to 21 days. All patients were advised to maintain supine position postoperatively. PFCL-Silicon oil exchange was done after 15-21 days. The outcomes were measured as complete retinal reattachment between the neurosensory retina (NSR) and retinal pigment epithelium (RPE), changes in postoperative visual acuity and complications. Patients were followed up for a minimum duration of 6 months. Data were analysed using SPSS version 23. RESULTS: In 39 out of 40 eyes (97.5%) retina was completely attached. Postoperative visual acuity was improved in 24 eyes (60%), while in 16 eyes (40%) it remained stable. Worsening of visual acuity was not noted in any case. During follow-ups, uveitis was detected in 2 eyes (5%), cataract in 4 eyes (10%), optic atrophy in 2 eyes (5%) and endophthalmitis and subsequently redetachment in 1 eye (2.5%). CONCLUSION: In complex inferior retinal detachments, PFCL is safe and effective postoperative tamponade provided it is used for a short-term period, especially in those patients who are noncompliant with postoperative face-down position. KEY WORDS: Perfluorocarbon liquid (PFCL), Postoperative tamponade, Complex inferior retinal detachments.
