Argon laser demarcation of AIDS-related cytomegalovirus retinitis in resource-limited setting.

PURPOSE: We evaluated outcomes associated with argon laser demarcation of cytomegalovirus (CMV) retinitis lesions to prevent retinal detachments amongst people with AIDS in a resource-poor setting.

METHODS

We performed a retrospective, longitudinal, observational cohort study of patients with AIDS-related CMV retinitis who were treated with laser demarcation to prevent retinal detachment during a 4-year period at a single facility in Yangon, Myanmar. The main outcomes were retinal detachment and loss of central visual acuity. We also evaluated a comparator group of patients who presented with AIDS-related CMV retinitis and concomitant retinal detachment.

RESULTS

Laser demarcation was performed on 45 eyes (38 patients). All were receiving combination antiretroviral therapy (cART). All treated eyes had inactive CMV retinitis lesions involving ≥ 25% of the retinal area. No eye developed a retinal detachment or loss of central visual acuity during follow-up for 3 years. In contrast, eyes that presented with retinal detachments that were surgically repaired experienced further loss of vision (6 of 14 eyes [42%]) and recurrent detachments (4 of 14 eyes [28.6%]).

CONCLUSIONS

Although laser demarcation of CMV retinitis lesions is not routinely performed in geographic regions where patients can be followed closely and have access to vitreoretinal surgeons, the procedure may be useful for some patients in resource-limited settings.