June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Acute onset of flashes and floaters; a review of posterior vitreous detachments at the Rush Eye Center, guidance for a large-scale national database analysis
Author Affiliations & Notes
  • Jonathan Minkowski
    Ophthalmology, Rush University Medical Center, Chicago, Illinois, United States
  • Mathew W MacCumber
    Ophthalmology, Rush University Medical Center, Chicago, Illinois, United States
    Illinois Retina Associates, Illinois, United States
  • Footnotes
    Commercial Relationships   Jonathan Minkowski, None; Mathew MacCumber, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4243. doi:
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      Jonathan Minkowski, Mathew W MacCumber; Acute onset of flashes and floaters; a review of posterior vitreous detachments at the Rush Eye Center, guidance for a large-scale national database analysis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4243.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : A retrospective chart review of patients with new onset PVD with analysis of initial presentation and outcomes to catalog risk factors for development of a tear or detachment. This study is a pilot study to guide a larger analysis of a major national patient database that may provide guidance on PVD management recommendations.

Methods : The electronic medical record of the Rush Eye Center was queried from 2017 through 2019 for patients with a diagnosis of PVD. Patients included had two months or less of either flashes or floaters and a documented PVD on initial exam. Patients with intraocular surgery, trauma within 6 months, or a tear or detachment on initial presentation were excluded. Exam data were analyzed as well as follow up timeline and development of retinal tear or detachment was recorded. This information was used to formulate inclusion and exclusion criteria for a large-scale query of a major national database, on ongoing project with approximately 30,000 patients meeting criteria for analysis.

Results : There were 50 eyes included in the pilot data set. The mean days of symptom onset prior to presentation were 8.3. The mean spherical equivalent was -2.17. 36 (72%) patients received an initial scleral depressed exam. 9 (18%) patients were pseudophakic. 5 (10%) patients had documented vitreous heme. 4 (8%) patients had anterior vitreous pigment. Average follow up was 5.2 weeks with 5 (10%) patients being lost to follow up. 24 (53%) patients received a scleral depressed exam on follow up examination. 2 (4.4%) patients developed a tear discovered on scheduled follow up examination. Those 2 patients who developed a tear had a mean spherical equivalent of - 8.25 and either vitreous heme or lattice on initial exam. The ongoing national database query has produced approximately 30,000 patients meeting criteria for analysis.

Conclusions : Flashes and floaters are a common presentation of posterior vitreous detachment. PVD may be associated with retinal tears or detachments. Practice patterns across eye care specialties differ widely. This pilot study contributed to the formulation of criteria for an ongoing major national database query which upon analysis may provide meaningful guidance on follow up recommendations for patients presenting with a new onset PVD. Preliminary results of the query of the larger dataset will be presented.

This is a 2020 ARVO Annual Meeting abstract.

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