Rhegmatogenous Retinal Detachments and Retinal Tears in Adult Retinopathy of Prematurity

Abstract

Purpose : To examine the functional and anatomic outcomes of retinal tears and rhegmatogenous retinal detachments in adults with a history of retinopathy of prematurity in the small-gauge (23- and 25-gauge) vitrectomy era.

Methods : Noncomparative, interventional retrospective study

Results : 220 eyes of 110 patients aged 15 years and older were included. 8 eyes presented with a retinal tear, whereas 16 eyes developed a retinal tear during follow-up. Eyes were followed for up to 29 years (median: 9.2 years). The mean age at which the first retinal tear developed on presentation was 45 years (range: 42-68). 6 eyes (3%) presented with a retinal detachment and during follow-up, 26 eyes (12%) developed a retinal detachment. Of those, 9 eyes (35%) required more than one surgery to achieve anatomic success. In eyes with no retinal detachment on presentation, the mean age of presentation of retinal detachment was 49 years (range: 18-62). Irrespective of stage of retinopathy of prematurity, when documented, even minimal peripheral avascularity were associated with a higher risk of developing a retinal tear or detachment.

Conclusions : Patients with a history of prematurity are at an increased risk of developing retinal tears and rhegmatogenous retinal detachments in their adult years. These occur earlier than the average population. Eyes that presented with minimal cicatricial changes on ophthalmoscopy, and angiographic evidence of peripheral avascularity were at high risk of developing a retinal tear or detachment in adulthood. This may have important implications for the use of anti-vascular endothelial growth factor agents for the management of retinopathy of prematurity. Adult patients who develop a retinal detachment or tear often require multiple surgeries to achieve anatomic and/or functional success

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.