Surgical management for treatment-resistant cases of inflammatory exudative retinal detachment: Mission impossible?

PURPOSE: To report the outcome of surgical intervention for inflammatory, exudative retinal detachment (ERD). METHODS: A retrospective analysis of eyes with ERD that underwent vitrectomy. RESULTS: Twelve eyes (10 patients) with ERD, non-responsive to medical therapy, underwent vitrectomy. The mean age was 35.7 ± 17.7 years. Five eyes (42%) had Vogt–Koyanagi–Harada disease, three (25%) had presumed tuberculosis (TB), two (17%) pars planitis, and one (8%) had sympathetic ophthalmia. The mean time of vitrectomy was 6.76 ± 4.1 months after onset. Six (50%) eyes had a recurrence, two settled with medical treatment, and four underwent re-surgery. The mean follow-up was 2.7 years. At the last visit, 10 (83.3%) eyes had attached retina; the best-corrected visual acuity (BCVA) had reduced to 1.6 ± 0.7 logarithms of the minimum angle of resolution (logMAR) from 1.3 ± 0.7 at baseline. CONCLUSION: Vitrectomy in ERD can act as an adjuvant to conventional medical therapy and help maintain structural integrity. Early vitrectomy may help preserve visual function.