The most common ocular findings were anomalies of retinal fundus and minor changes in the outer region of the eyes. The authors noted better VA and less severity of disease than others, which might be due to a different selection of patients, different pattern of alcohol consumption, or genetic differences.

Cytomegalovirus (CMV) retinitis may occur in profoundly immunocompromised patients and be the initial AIDS-defining infection. The incidence and prevalence of CMV retinitis has declined substantially in the era of highly active antiretroviral therapy (HAART); nevertheless, it remains a leading cause of ocular morbility. We report the case of a 40-year-old man with blurred vision and pain in the right eye, three weeks after the initiation of effective HAART treatment. Ocular examination revealed a panuveitis causing an anterior chamber reaction with hypopyon and a dense vitreous haze. An endogenous endophthalmitis was suspected and treatment was ensued, without improvement. A vitreous tap was performed, and a positive polymerase chain reaction for CMV was found. A diagnosis of immune recovery uveitis (IRU) was made, and the patient responded to treatment with valganciclovir and dexamethasone. IRU is an intraocular inflammation that develops in patients with HAART-induced immune recovery and inactive CMV retinitis, although cases of active CMV retinitis have been described. Presentation with panuveitis and hypopion is rare and may be misleading regarding diagnosis and management.

The purpose of this case report is to describe a modified technique involving the use of an autologous neurosensory retinal free flap for closure of a macular hole (MH) during retinal detachment (RD) surgery. A 50-year-old female presented with sudden vision loss (light perception only) and a recurrent myopic RD associated with an MH. An autologous neurosensory retinal free flap was obtained and moved toward the MH. Silicone oil was used as an endotamponade and removed after 6 months. Two months after oil removal visual acuity improved to 20/400 and remained stable thereafter; however, the patient developed central retinal atrophy. One year after surgery the MH was closed and the retina attached. This modified technique with the use of an autologous neurosensory retinal flap provides an alternative approach for recurrent MH in RD procedures.

Purpose: To analyse the anatomical and functional outcomes of pars plana vitrectomy combined with retinotomy alone in primary inferior rhegmatogenous retinal detachments (RD). Methods: Data from 139 patients who underwent vitreoretinal surgery for inferior RD in Centro Hospitalar Vila Nova de Gaia/Espinho, between 2012 and 2021 by the same surgeon, were analysed. Univariate and multivariate analysis were performed. Outcomes such as visual acuity (VA) and occurrence of complications were studied. Results: From the total 139 eyes analyse, 72 were subject to vitrectomy combined with retinotomy. Among them, 79% had macula‐off at the time of surgery and 94.4% had proliferative vitreoretinopathy (grade B or C). Functional success, with VA improvement or stabilization after surgery, was 75%. VA was significantly improved from 1.61 to 0.73 logarithm of the minimal angle of resolution units (p < 0.001). The anatomic success rate was 95.8% in the first surgery. Conclusions: Inferior RD is a significant clinical and surgical challenge for vitreoretinal surgeons and the choice between the best surgical technique is still controversial. These cases frequently require some additional measures to vitreoretinal surgery due to its high recurrence rate. Our results show that vitrectomy with retinotomy alone on primary inferior RD has high anatomical and functional success rates.

PurposeTo report the surgical outcomes of pars plana vitrectomy (PPV) with inferior retinotomy without the need for scleral buckling in primary inferior rhegmatogenous retinal detachment (RRD) with inferior retinal breaks and Proliferative vitreoretinopathy (PVR) grades B or C.MethodsRetrospective, consecutive series, single‐center study of patients that underwent PPV with inferior retinotomy for primary inferior RRD with inferior retinal breaks (4:00 to 8:00 clock hours) and PVR grades B or C. Data were obtained from patients’ medical records from October 2014 to November 2020. The primary outcomes of the study were retinal reattachment and visual acuity improvement. Data collected before and after surgery was compared between groups using chi‐square analysis and paired samples t‐test. The resulting p‐values significance level was set at p = 0.05.ResultsThirty‐two patients (32 eyes) met the inclusion criteria. PVR in stage B was present in 19 patients and stage C in 13 patients. Macula‐off RRD was diagnosed in 25 patients while the other 7 patients had RRD with the macula attached. Regarding primary outcomes, 31 out of 32 (97%) patients achieved retinal reattachment with no differences between PVR groups (p = 0.406). The best‐corrected visual acuity (BCVA) improved significantly in eyes with macula‐off RRD at presentation (p < 0.001). Although macula‐attached RRD eyes had higher final BCVA, its improvement was not statistically significant (p = 0.370). Besides one retinal redetachment, no other significant complications were reported after surgery.ConclusionsInferior retinal breaks are associated with surgical failure following PPV for inferior RRD repair, especially if advanced PVR is present. Our results suggest that, in these less common and more challenging cases, PPV with an inferior retinotomy is associated with very favorable anatomic and visual outcomes.