Abstract
Purpose :
To evaluate the outcomes of second eye rhegmatogenous retinal detachments (RRDs) in patients with a history of RRD to assess the impact of RRD education.
Methods :
This is a retrospective chart review of all patients at a single tertiary retina practice with a history of bilateral, sequential RRDs. Patients were excluded if they had a history of globe rupture, tractional retinal detachment due to retinovascular disease, or posterior uveitis. Additionally, if both eyes developed RRDs at initial presentation then they were excluded. Outcomes were compared between initial RRD eye and the second eye as all patients are educated regarding the symptoms of an RRD following such a diagnosis. The primary outcome measure was final visit best corrected visual acuity (BCVA). Other outcomes assessed including macular status at presentation, BCVA at presentation, and length of symptoms (LOS) prior to presentation.
Results :
In total 103 patients with bilateral, sequential RRDs were included. Of the 91 patients with available data, final BCVA was significantly better in the second eye when compared to the first eye, 0.47±0.14 logMAR (20/59) versus 0.59±0.19 logMAR (20/77), respectively (p=0.02). Further, patients presented with a significantly better BCVA in their second eye of 0.38±0.20 logMAR (20/48) compared to the first eye of 0.83±0.33 logMAR (20/136, p=0.03). This may be related to the much higher frequency of macula-on RRDs in the second eye compared to the first eye. Of the 36 first eyes with documented macular status 36.1% (n = 13) where macula-on compared to 58.3% (n = 48) in the 84 second eyes with documented macular status (p = 0.026). Lastly, 25 patients had documented LOS in both eyes with 60% of first eyes (n = 15) presenting >1 week after symptom onset. On the other hand, 68% of second eyes (n = 17) presented within 3 days of symptom onset.
Conclusions :
Patients with bilateral sequential RRDs routinely present with less advanced pathology when an RRD occurs in their second eye. As would be anticipated, these eyes have significantly better visual outcomes. Importantly, this fails to encapsulate the subset of patients with a history of RRD who present prior to second eye RRD with treatable retinal tears. The patient education provided to such patients is paramount to this difference and as an ophthalmologic society we must be better in educating the general population regarding the symptoms associated with an RRD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.