Inflammatory Rhegmatogenous Retinal Detachment: Incidence and Outcome of Rhegmatogenous Retinal Detachments in Posterior Uveitis

Abstract

BACKGROUND: Uveitis is one of the cause for blindness in our country in all age group of patients. Various causes of uveitis have been reported in our institute. All uveitis will not cause blindness, if appropriately managed. Blindness is mainly due to complications which occur as sequalae in these patients. Blindness can be due to anterior or posterior segment involvement. Early presentation and management will help in controlling the various complications. Rhegmatogenous retinal detachment is one of the cause in posterior uveitis patients which can occur due to changes in vitreous and retina. Uveitis can be infective or non-infective. AIM: Purpose of our study is to assess the incidence, management and outcome of rhegmatogenous retinal detachment in uveitis patients. MATERIALS AND METHODS: All patients of uveitis presented to our vitreo retina department were examined in detail, underwent various investigations to know the aetiology and managed based upon the clinical presentation. Retrospective study done by collecting patient data from old medical records. Duration of the study is 5 years, from June 2014 to June 2019. No of patients presented with posterior uveitis to our department during June 2014 to June 2019 were 610. All these patients underwent BCVA, Slit lamp examination, IOP, Fundus examination, b scan, OCT and documentation. Systemic examination done in all cases and also laboratory work up like RBS, CBP, MANTOUX TEST, HIV and serological testing if required, rheumatological work up in suspected cases. Patients with inflammatory rhegmatogenous retinal detachment underwent buckling plus pars plana vitrectomy and silicone oil endo tamponade. Fellow eye if required prophylactic laser done to the necrotic areas and when necrotic or tractional retinal breaks were present. RESULTS: Patients with mild PVR changes had good anatomical outcome, patients with severe PVR changes showed poor anatomical outcome. Visual outcome was poor in almost all cases. BCVA in all cases after oil removal was CF ½ mt to CF 1mt, some cases showed very poor outcome, BCVA in those cases was only perception of light in spite of good anatomical outcome. CONCLUSSION: Inflammatory retinal detachment is very serious condition in uveitis cases, PVR is definitely a poor prognostic factor, patient requires prolong endotamponade. Cases with prolong duration of uveitis history showed poor outcome. Even early presentation of cases also showed not much favourable visual outcome.