Abstract
Purpose :
Horseshoe retinal tears (HRT) can progress to retinal detachments (RD) if untreated. While there are known risk factors for HRT development, there is little data related to risk factors for HRT development in the fellow eye (FE) after HRT development in one eye. The purpose of this study was to investigate risk factors associated with HRT development in the FE of patients with HRT in one eye.
Methods :
Medical records were reviewed for patients with initial HRT between October 1, 2015 and December 31, 2017 at a large, urban, retina practice. Eyes were excluded if they had prior HRT or RD treatment, a concurrent RD at initial visit, or only 1 visit; eyes with localized RD were included if treatment consisted of cryotherapy or laser demarcation. Vitreous attachment status was graded using presenting macula optical coherence tomography (OCT) images with a four-stage method: 0=fully attached, 1=extra foveally attached, 2=foveally attached, 3=fully detached in view, 4=fully detached out of view. Logistic regression was used to assess factors associated with FE HRT including FE and study eye (SE) posterior vitreous detachment (PVD) status, SE subsequent breaks, SE vitreous hemorrhage (VH), and SE lattice degeneration.
Results :
246 patients presented with an HRT in the SE during the inclusion period with a mean follow up of 68.8 months (median 30.2; IQR 8.0-125.9). Among patients who had an intervention (244, 99.2%), the majority received laser demarcation (239, 98.0). 40 (16.3%) patients developed a FE HRT, and experienced floaters (22, 55%), flashes (8, 20%), blurred vision (5, 12.5%), eye pain (1, 2.5%), light sensitivity (1, 2.5%), and shadow (1, 2.5%), while 7 (17.5%) patients were asymptomatic. Mean time between SE HRT and FE HRT was 6.2 months (median 1, range 0-46). Logistic regression demonstrated an association between occurrence of FE HRT and a stage 3 PVD at the time of initial SE HRT (p=0.0283). There was also an association between FE HRT and the development of subsequent breaks in the SE (p=0.00124). There were no associations between FE HRT and SE VH (p=0.86), SE PVD (p=0.7719), or SE lattice degeneration (p=0.0874).
Conclusions :
The current study found statistically significant associations between development of FE HRT and (1) stage 3 PVD in the FE at the time of SE HRT presentation and (2) subsequent HRT in the SE. These factors may be important to consider in the clinical management of patients with HRT.
This is a 2021 ARVO Annual Meeting abstract.