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S.F. Ho, A. Fitt, M. Benson; Risk for Progression of Macula–On Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5492.
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Purpose: To establish the likelihood and risk factors associated with progression of macula–on retinal detachment. Methods: A multi–centre prospective observational study of patients with acute macula–on retinal detachment was conducted over a six month period. Data collected included age, gender, date of presentation, affected eye, duration and type of symptoms, visual acuity, retinal drawing, subretinal fluid (SRF) distance from the centre of the fovea in disc diamters, presence of vitreous detachment, lens status, presence of myopia, date of operation, distance of SRF from the fovea at surgery, and surgical results at 6 weeks follow–up. Results: 82 data sets from 15 institutions were analyzed. Mean patient age was 51 years (range 18–53). Only 11 of 72 cases demonstrated progression of fluid (probability 11/82 –– 13.4%, 95% confidence interval: 13.1% – 13.7%). Mean progression was 2.3 disc diamter (SD: 1.9, range 0.5–6). The rate of progression was 1.58 disc diameter/day. Binary regression analysis failed to reveal any statistically significant risk factors associated with progression. Multiple regression analysis were made to identify risk factors. With distance of SRF from fovea at operation as a function, distance of SRF at presentation was the only statistically significant risk factor. 26% patients underwent surgery out of hours. 83% patients achieved 6 weeks best–corrected vision of 6/9 or better. Conclusions: Most (89%) macula–on retinal detachment in this study did not progress within the first few days. The progression of macula–on retinal detachment did not relate to: duration of retinal detachment, quadrantic involvement, location of SRF above midline, or presence of vitreous detachment. The distance of SRF from the fovea at presentation was the only statistically significant risk factor for progression to macular detachment.
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