Abstract
Purpose :
To study the racial differences in outcomes of full thickness macular hole (FTMH) repair following pars plana vitrectomy (PPV) between white and black patient population groups.
Methods :
A retrospective cohort study was performed using TriNetX (Cambridge, MA, USA), a federated electronic health records research network comprising multiple health organizations in the United States. Patients who underwent PPV for FTMH repair were identified and categorized into white and black cohorts. The primary outcomes were retinal tear (RT), retinal detachment (RD) with retinal break, serous RD, epiretinal membrane (ERM), macular hole (MH), macular edema (ME), macular degeneration (MD), glaucoma, cataracts, retinal vein occlusion (RVO), retinal artery occlusion (RAO) and endophthalmitis. Outcomes were compared 90-days postoperative between the groups after propensity score matching using logistic regression and greedy nearest-neighbor matching algorithm.
Results :
A total of 2,974 patients were included in the analysis with 1,487 patients in each of the white and black cohorts after propensity matching. At the 90-day postoperative period, black patients had a significantly greater risk of developing macular hole (RR 1.35; 95% CI 1.23,1.49) while white patients had a significantly greater risk of developing RD with retinal break (RR 1.62; 95% CI 1.19,2.21), glaucoma (RR 0.75; 95% CI 0.62,0.9), ERM (RR 2.52; 95% CI 2.07,3.07), ME (RR 2.83; 95% CI 1.79,4.49), and MD (RR 3.30; 95% CI 1.63,6.67). No significant difference was noted in the development of RT, serous RD, cataracts, RVO, RAO and endophthalmitis. The incidence of a second vitrectomy for FTMH repair within the 90-day period was similar in both cohorts (4.8% vs 4.0%).
Conclusions :
Racial differences are apparent when evaluating outcomes after FTMH repair. While white patients have a greater risk of post-operative complications when compared to black patients, black patients were noted to have a greater risk of post-operative MH suggesting that the post-operative recovery time period for black patients may be longer compared to white patients.
This is a 2021 ARVO Annual Meeting abstract.