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J. Pastor, E. Rodriguez de la Rua, F. Martin, A. Mayo, M.A. de la Fuente, R.M. Coco; Clinical and Surgical Features of Retinal Shortening: The Most Severe and Less Recognized Form of Proliferative Vitreoretinopathy (PVR) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2979.
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Purpose: To identify the clinical characteristics of patients showing retinal shortening due to intraretinal PVR (iPVR), taking into account that this form of PVR has not been clearly defined in the currently accepted classifications. Methods: Observational and retrospective cohort study. 84 out of 110 consecutives cases of PVR operated in 2000 and 2001 were included and classified into two groups according to their surgical findings. Group 1 (iPVR): cases with retinal shortening unrelated to epiretinal or subretinal membranes. This circumstance was evidenced during vitrectomy, when retinal reapplication with perfluoro-liquids or air was not fully obtained. Group 2 (No iPVR): cases without evidence of retinal shortening after peeling of membranes. Main preoperative clinical variables of the sample were colleted. Statistical analysis was performed by the chi-square test. Results: 60 (54.5%) cases (CI95% 40.5-68.5) showed surgical evidence of iPVR (Group 1) and 24 (21.8%) (CI95% 12.9-30.7) did not (Group 2). 26 (23.6%) cases could not be classified because the surgical evaluation was not conclusive. In group 1, mean age was 58.43 ± 14.1, median time of evolution was 60 days (interquartile range: 75 days), 55% were postoperative PVR, 30% aphakic or pseudophakic, 58% have retinal breaks less than 1 hour clock and 41.7% have not breaks visible. In group 2 mean age was 58.6 ± 16.8, median time of evolution was 60 days (interquartile range: 60 days), 45.8% were postoperative PVR, 47% aphakic or pseudophakic, 41% have retinal breaks less than 1 hour clock and 33.0% have not breaks visible. Differences were not statistically significant between groups in any of these variables. In 9 out of 60 cases with iPVR a retinectomy was necessary to reattach the retina. The number of cases with more than 60 days of evolution (20.7%) was significantly higher in patients in which retinectomy was performed than in the rest of the group 1 cases (3.7%) (p=0.04). Conclusions: Retinal shortening is a circumstance frequently find in PVR and can be considered as a severe variety of this complication (intraretinal PVR or iPVR) probably related with long evolution time of RD. Nevertheless it is not very well documented in literature, therefore more studies focused on the pathological, clinical and surgical characteristics of this variety of PVR are necessary.
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