       Document 0010
 DOCN  M9620010
 TI    Silicone oil in repair of retinal detachments caused by necrotizing
       retinitis in HIV infection [see comments]
 DT    9602
 AU    Davis JL; Serfass MS; Lai MY; Trask DK; Azen SP; Department of
       Ophthalmology, Bascom Palmer Eye Institute,; University of Miami, Fla.,
       USA.
 SO    Arch Ophthalmol. 1995 Nov;113(11):1401-9. Unique Identifier : AIDSLINE
       MED/96048997
 CM    Comment in: Arch Ophthalmol 1995 Nov;113(11):1366-8
 AB    OBJECTIVE: To evaluate the safety and efficacy of 1000- and
       5000-centistoke silicone oil as retinal tamponades for the treatment of
       retinal detachments secondary to necrotizing retinitis in patients with
       human immunodeficiency virus (HIV) infection. DESIGN: A prospective
       observational study. SETTING: Community and university-based
       ophthalmology clinics. PATIENTS: Three hundred fifty patients with HIV
       infection, who had 407 eyes with retinal detachments secondary to
       necrotizing retinitis. INTERVENTION: Vitrectomy surgery for retinal
       detachment with 1000- or 5000-centistoke silicone oil as the retinal
       tamponade. OUTCOME MEASURES: Efficacy was measured both by anatomic
       success (defined as complete retinal attachment or macular attachment)
       and by visual acuity success (defined as preservation of visual acuity
       or ambulatory vision). Safety was determined by the rate of
       complications, including abnormal intraocular pressure and corneal and
       lens opacification. RESULTS: At the last follow-up examination, the
       retina was completely attached in 287 (73%) of 393 eyes, the macula was
       attached in 370 eyes (94%), 268 eyes (68%) had ambulatory vision, and
       visual acuity was preserved in 219 (56%) of 388 eyes. Corneal
       opacification, hypotony, and silicone oil emulsification were present in
       4%, 2%, and 1% of eyes, respectively. One eye had elevated intraocular
       pressure. Of the 57 patients who had both eyes treated, 35 died, of whom
       four (11%) had nonambulatory vision in both eyes. Of the 293 patients
       who had one eye treated, 122 died, of whom 44 (36%) died with
       nonambulatory vision in the treated eye. The median time to cataract was
       192 days; to nonambulatory vision, 474 days; and to death, 204 days.
       CONCLUSIONS: Silicone oil repair of retinal detachments in necrotizing
       retinitis is an efficacious and safe procedure that delays or prevents
       loss of vision in advanced HIV disease.
 DE    Adult  Cohort Studies  Comparative Study  Female  Follow-Up Studies
       Human  HIV Infections/*COMPLICATIONS  Male  Prospective Studies  Retinal
       Detachment/ETIOLOGY/*SURGERY  Retinal Necrosis Syndrome,
       Acute/*COMPLICATIONS  *Silicone Oils  Treatment Outcome  Viscosity
       Visual Acuity  Vitrectomy  JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

