RD occurs in half of ARN eyes1
—35.3% of prophylactically lasered eyes still develop RD2
; 96.3% of RDs occur 3 weeks after presentation.2
Visual acuity after surgical repair only improves in a third of patients.2
Pre-retinal fibrosis and severe anterior PVR changes characterise rhegmatogenous RD (RRD) in ARN.3
Vitrectomy, silicone oil tamponade and mid periphery laser4
are recommended treatment for viral related detachments due to the presence of multiple breaks.
Scleral buckling may be omitted in cytomegalovirus related detachments in which there is very minimal PVR, unlike in this case.4
Other studies considered use of vitrectomy and scleral buckle without silicone oil,5
highlighting the importance of prophylaxis for anterior PVR in these cases with use of a buckle. Early vitrectomy with intravitreal aciclovir is a new option under study.6
There was no published study describing a macular hole detachment in ARN.
- Posterior fibrosis in ARN may lead to a macular hole.
- Macular hole in ARN may rapidly lead to rhegmatogenous RD (RRD) within days.
- PVR changes in ARN-RRD progress rapidly.
- Prophylactic scleral buckle during primary vitrectomy is recommended when anterior cortical vitreous is adherent in ARN-RRD and for missed breaks.