Abstract
Purpose :
To investigate the incidence of delayed retinal breaks and detachments after diagnosis of acute, symptomatic posterior vitreous detachment (PVD) in an ophthalmology resident-run urgent care clinic (UCC), and whether there is a significant difference in this incidence depending on whether the UCC visit was staffed by a retina specialist, non-retina ophthalmology attending, optometrist, or ophthalmology resident.
Methods :
Retrospective consecutive case series. The study was deemed exempt from review by the institutional review board. Records were reviewed of all patients evaluated in the ophthalmology UCC of an academic medical center with a diagnosis of acute PVD between January 1, 2017 and December 31, 2018. Patients with an acute retinal tear or detachment on presentation, media opacity precluding view for clinical retina examination, or no follow-up ocular examination within one year of the UCC visit were excluded.
Results :
Among the 254 included study eyes, a delayed retinal tear was found in 5 (2.0%) (at 8, 28, 39, 41, and 41 days following the UCC visit) and delayed detachment in 1 (0.4%) (at 7 days following the UCC visit). All of the delayed breaks and detachment were found <6 weeks after the UCC visit. Mean follow-up was 147 days; all patients had at least 1 week of follow-up, 230 (90%) had at least 4 weeks of follow-up, and 192 (76%) had at least 6 weeks of follow-up. The incidence of delayed retinal tear or detachment was 3/161 (1.9%) among cases staffed by a retina attending, 1/35 (2.9%) among cases staffed by a non-retina ophthalmology attending, 1/38 (2.6%) among cases staffed by an optometrist and 1/20 (5%) among cases staffed by an ophthalmology resident. There was no significant difference among groups with respect to the incidence of delayed retinal tear/detachment (p = 0.846). There was no significant difference in follow-up duration among the groups (p = 0.580).
Conclusions :
There was no difference in the incidence of delayed retinal breaks and detachments between cases staffed by retina attendings compared to those staffed by non-retina ophthalmology attendings, optometrists, or ophthalmology residents.
This is a 2020 ARVO Annual Meeting abstract.