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Vishal Swaminathan, Rachel Israilevich, Eli Cehelyk, Mirataollah Salabati, Raziyeh Mahmoudzadeh, Joshua Uhr, Jason Hsu; Outcomes of Early Onset Versus Delayed Rhegmatogenous Retinal Detachments after Acute Posterior Vitreous Detachment. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3401 – F0301.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomic and functional outcomes of eyes presenting with early onset versus delayed RDs following acute PVD.
This was a retrospective, comparative, interventional cohort study of patients who presented with delayed RDs (>42 days after initial presentation to a retinal specialist with acute PVD) compared to an age- and gender-matched control cohort who presented with early onset RDs (PVD and RD at initial visit to a retina specialist). All eyes underwent retinal detachment repair from October 1, 2015 to March 31, 2020. The primary outcome was the final attachment rate and single surgery anatomic success (SSAS) at 3 months.
Seventy-one patients presented with delayed RDs and 147 matched controls presented with early onset RDs. Patients with delayed RD had a mean (SD) baseline logMAR VA of 0.20 (0.37) [Snellen, 20/32] at the initial presentation with an acute PVD, which then decreased to 0.50 (0.70) [Snellen, 20/63] at the time of RD diagnosis (p<0.001). The mean VA of the early onset RD group was 1.03 (0.92) [Snellen, 20/214]. There was a significant difference between the mean VA of these groups at the time of RD presentation (p<0.001). The mean VA was better at month 1 and 3 post-RD repair in the delayed RD group compared to that of the control group (p=0.004 and 0.03, respectively). No significant difference was found when comparing the mean VA at 6-months post-repair, 12-months post-repair, or at the final visit (p=0.43, 0.32, and 0.21 respectively). SSAS was 59/71 (83.1%) for the delayed RD group and 117/147 (79.6%) for the early onset RD group (p=0.54). In the delayed RD group, 31/71 (43.7%) eyes had a macula-off RD while in the control group 98/147 (67.5%) eyes were macula-off (p=0.002).
Delayed RDs occurring more than 6 weeks after initial presentation with an acute PVD generally had better VA at the RD diagnosis visit and faster post-surgical visual recovery compared to RDs diagnosed at the initial presentation to a retina specialist. While no significant difference in anatomic outcomes was seen between the two groups, a greater proportion of patients presented with macula on RDs in the delayed RD group, perhaps suggesting that RD warnings given at earlier visits may be beneficial.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Table 1. Baseline characteristics of patients.
Table 2. Visual acuity outcomes.
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