Abstract
Purpose :
Study the anatomic and functional outcomes of surgery in uveitic non-exudative retinal detachment (NERD).
Methods :
Retrospective case series of consecutive eyes with uveitic NERD undergoing surgery between January 2012 and December 2019.
Results :
75 eyes of 70 patients were included. The etiology of intraocular inflammation causing NERD was infectious in 73.3% of cases, immune in 9.3% of cases, tumoral in 2.7% of cases and idiopathic in 14.7% of cases. Posterior and panuveitis accounted for 96.4% of included eyes. Proliferative vitreoretinopathy (PVR) was present in 28.2% of eyes at baseline. The first surgery consisted in vitrectomy alone, scleral buckling alone (SB) or both in respectively 88%, 4% and 8% of cases. Reattachment rate was 75 % after 1 surgery (100% in case of SB) and 89.3% after ≥ 2 surgeries. The mean best corrected visual acuity (BCVA) was 1.5±0.8 logMAR at presentation improving to 1.1±0.9 logMAR at the last follow up (36.6±23.5 months). At the last follow up, 66,6% of eyes reached a countable BCVA (≥20/400 Snellen). After multivariate analysis, the predictive factors of final BCVA≥20/400 were: having baseline BCVA≥20/400(OR=6.1,p=0.01), inactivity of baseline ocular inflammation (OR=0.2 for active inflammation, p=0.015) and absence of retinal detachment (RD) relapse during the follow up (OR=0.1 for RD relapse, p=0.001). The predictive factors of final retinal reattachment were: having baseline BCVA≥20/400(OR=11.3, p=0.05), and absence of relapse within the first 6 weeks of surgery (OR=0.1 for RD relapse, p=0.03).
Conclusions :
When managed properly, uveitic NERD has a good anatomic outcome especially when SB is used. For the first time, presence of active inflammation at the time of RD seems to cause the poorest visual outcomes. This should urge physicians adopt the most adequate perioperative anti-inflammatory strategy.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.