A Survey of Retina Specialists’ Perspective on Symptomatic Vitreous Floaters (SVF) and its Management

Abstract

Purpose : SVF have been shown to decrease subjective visual function (National Eye Institute (NEI)-standardized visual function questionnaire (VFQ)) and contrast sensitivity (CS). Pars plana vitrectomy (PPV) and yttrium-aluminum-garnet (YAG) vitreolysis are currently used to treat this condition. The former demonstrated a high success rate with improvement in subjective visual function and CS albeit potential perioperative complications. On the other hand, previous YAG vitreolysis studies were not as robust due to study design variability, small sample size and subjective outcome reporting. However, a recent published trial¹ on YAG vitreolysis reported symptoms improvement (including NEI-VFQ). The aim of this study is to gain the insight of retinal specialists regarding the treatment of floaters.

Methods : An electronic survey consisting of 10 multiple choice questions were distributed to retina specialists registered under the American Society of Retina Specialists. Chi-square test was used for statistical analysis.

Results : 167 retinal specialists completed the survey. A majority were in private practice (82.2%) and 70.9% were in practice for more than 10 years. SVF were considered debilitating by 97.0% of respondents and treatment was only performed if vitreous floaters were debilitating (92.1%). 24.2% of respondents treat at least once a month and 58.2% treat once in 6 months. PPV (79.1%) was more commonly performed compared to YAG vitreolysis (0.6%; P <2.2e-16), while 3.7% would perform both procedures. Furthermore, 16.6% do not treat SVF. Concerns with YAG treatment include risk of retinal tear/detachment (63.4%), inadequate data (61.0%) and ineffective treatment (56.7%). 30.2% would still consider YAG vitreolysis at some point in time but 32.7% would never adopt this procedure. Lastly, only 12.3% thought that it was appropriate for non-retina ophthalmologist to be performing YAG vitreolysis.

Conclusions : Most retinal specialists consider SVF a debilitating condition and would treat if the condition is incapacitating. Most performed PPV; furthermore, a majority of respondents has not used YAG vitreolysis and this could be attributed to concerns of developing complications as well as the lack of data for its efficacy. This survey suggests that most retinal specialists will either continue to educate patients and observe and/or perform PPV for SVF until more data are available for YAG vitreolysis.

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