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Palak Patel, Omar Dajani, Jonathan Minkowski, Nicholas Boucher, Mathew W MacCumber; Analysis of PVD and Development of Complications using a Large Database of Retina Specialists. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1937.
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© ARVO (1962-2015); The Authors (2016-present)
Significant variability exists in the monitoring of acute posterior vitreous detachments (PVD) across ophthalmologists. This retrospective analysis hypothesizes that certain factors are associated with greater incidence of complications. It also examined the rate of delayed complications up to 6 months after initial presentation.
A case-control study of 9,635 eyes with symptoms for no more than 4 weeks prior to diagnosis were followed. Those eyes with a history of diabetic retinopathy, vitrectomy, retinal detachment, or panretinal photocoagulation were excluded. Cases were reviewed from the Vestrum database and included data from 65 retina practices and 316 individual physicians. Average age was 63 years old. Outcome measures included rate of development of vitreous hemorrhage, retinal detachment, or retinal tear at initial presentation, 3 months, and 6 months following initial presentation. Statistical analysis was done using a two-tailed t-test.
Of 9,635 eyes, 12.2% (1,172 eyes) had retinal tears and 3.1% (299 eyes) had detachments at initial presentation. By 6 month follow-up, 3.1% (295 eyes) developed retinal tears and 1.1% (104 eyes) developed detachments. Among those with a tear, 61% occurred within one month after presentation, 28.5% within 1-3 months, and 10.5% within 3-6 months. Among those with a detachment, 48% occurred in the first month, 35.6% within 1-3 months, and 16.3% within 3-6 months. Men were more likely to have a detachment at presentation (57% vs. 43%, p=0.025) and within 6 months of presentation (67% vs 33%, p<0.0006). Phakic eyes compared to pseudophakic eyes were more likely to develop retinal breaks at presentation (44% vs. 16%, p=<0.00001) and within 6 months of presentation (39% vs. 18%, p<0.00001). They were also more likely to have a detachment at initial presentation (37% vs. 25%, p=0.011). Peripheral retinal degeneration also correlated with increased retinal detachments at initial presentation (62% vs. 38%, p<0.00006).
Male sex, phakic eyes, and peripheral retinal degeneration were associated with increased incidence of complications after acute PVD, specifically retinal detachments. Several complications were also noted up to 6 months following initial presentation warranting appropriate counseling and consideration for repeat examination even up to 6 months after initial presentation.
This is a 2021 ARVO Annual Meeting abstract.
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