Abstract
Purpose :
To compare race-related differences in outcomes following pars plana vitrectomy (PPV) for retinal detachment (RD) in the postoperative period between individuals of black and white descent.
Methods :
A retrospective cohort study was conducted using TriNetX (Cambridge, MA, USA), a federated electronic health records research network comprising multiple large health organizations in the United States. Patients who underwent PPV for RD were identified by CPT code and stratified into black and white cohorts. Cohorts were matched for age, gender, and medical comorbidities (hypertension, diabetes mellitus, cerebrovascular disease, heart failure, nicotine dependence, alcohol related disorders, and body mass index). The primary outcomes were: retinal tear (RT), RD with retinal break, serous RD, epiretinal membrane (ERM), macular edema (ME), cataract, macular hole (MH), macular degeneration, papilledema, retinal vein occlusion (RVO), retinal artery occlusion (RAO), conjunctivitis, dry eye, optic neuritis, other disorders of optic nerve, decompression of the orbit, and endophthalmitis. Outcomes were compared between the cohorts after propensity score matching using logistic regression and greedy nearest-neighbor matching algorithm.
Results :
A total of 3,516 patients were included in analysis with 1,758 in each of the black and white cohorts after propensity matching. The white cohort had a significant greater risk of developing RT (RR, 0.47; 95% CI, 0.26-0.85), RD with retinal break (RR,0.76; 95% CI, 0.7-0.82), serous RD (RR, 0.65; 95% CI, 0.58-0.73), ERM (RR, 0.52; 95% CI, 0.34-0.79), ME (RR, 0.47; 95% CI, 0.28-0.77), and cataract (RR, 0.56; 95% CI, 0.39-0.8) whereas the black cohort had a significant greater risk of developing a MH (RR, 1.74; 95% CI, 1.2-2.53). No significant difference was seen in rate of development of macular degeneration, papilledema, RVO, RAO, conjunctivitis, dry eye, optic neuritis, other disorders of optic nerve, decompression of the orbit, or endophthalmitis between the black and white cohorts.
Conclusions :
Race is an important consideration when evaluating for complications following PPV for RD. Whites were more likely to develop RD, ERM, ME, and cataracts whereas blacks were more likely to develop MH. These differences should be considered when evaluating and discussing outcomes with patients both pre and post-operatively.
This is a 2021 ARVO Annual Meeting abstract.