Abstract
Purpose :
Retinal tears can occur during the formation of a posterior vitreous detachment (PVD) or afterwards. The goal of this study is to determine the incidence of and predictive risk factors for the development of late-onset retinal tears in patients presenting with an acute, symptomatic PVD.
Methods :
This is a retrospective, consecutive case series of patients diagnosed with an acute, symptomatic PVD at a tertiary eye center in 2015. Acute and symptomatic PVD was defined as experiencing flashes and/or floaters for 3 months or less at the time of PVD diagnosis. Patients with chronic or asymptomatic PVD or with a retinal tear/detachment at or before the time of PVD diagnosis were excluded. The occurrence and time of occurrence of subsequent retinal tears following initial PVD diagnosis was recorded, as well as additional patient information: age, sex, race, refractive error, lens status, lattice status, and type of physician (retina specialist versus non-retina specialist) that saw the patient.
Results :
A total of 104 eyes from 104 patients were found to have acute and symptomatic PVDs without concurrent retinal tears/detachments on diagnosis. Average follow-up time was 2.28 ± 1.33 years (range = 0.01-4.32). Kaplan-Meier analysis showed that 10.02% of eyes developed late-onset retinal tears by 4 years after initial PVD diagnosis. Of these late-onset tears, 50% occurred within 3.45 months of PVD diagnosis. Cox-Mantel log-rank analysis showed that younger patients (age < 60 years versus age > 60 years; p = 0.037), patients with lattice (p = 0.000), and patients who saw a retina specialist (p = 0.006) were more likely to develop late-onset tears.
Conclusions :
Patients with acute, symptomatic PVDs without a retinal tear/detachment at initial diagnosis often ask about their likelihood of developing a future tear. This study demonstrates that 10.02% of these patients develop late-onset retinal tears by 4 years after PVD diagnosis. Of patients who develop late-onset tears, 50% do so within 3.45 months of PVD diagnosis. Significant risk factors for late-onset tears include young age and lattice. Patients who see a retinal specialist are also more likely to be diagnosed with a late-onset tear. These findings may help guide how closely PVD patients should be followed to detect the occurrence of late-onset retinal tears.
This is a 2020 ARVO Annual Meeting abstract.