Abstract
Purpose :
A Retrospective cohort study was performed to describe the postoperative longitudinal visual acuity (VA) following rhegmatogenous retinal detachment (RRD) repair with pneumatic retinopexy (PnR) versus pars-plana vitrectomy (PPV) by assessing area under curve visual acuity.
Methods :
1000 patients with primary rhegmatogenous retinal detachment presenting to St. Michael’s Hospital, Toronto, from October 2009 to May 2023, were assessed for their visual acuity, intraocular pressure (IOP) and fundus examination at baseline, postoperative day 1, week 1, months 1,3,6 and 12 respectively. Patients with vision loss >3 months, PVR > grade B, a demarcation line, and previous history of retinal pathology or intervention were excluded. Visual acuity was plotted against time to represent the area under the curve for vision over the course of 1 year.
Results :
68.8% (661/961) were male with a mean age of 60.35 ± 11.38 years old.
59.1% (557/961) were phakic and 55.4% (531 /961 )had a fovea involving RRD at presentation. The mean presenting logMAR visual acuity was 0.96(SD 0.9 ) in the PnR group vs 1.12(SD 1.24) in PPV (P=0.7). 80.7% (774/1000) of patients underwent PnR and 19.3 % 185/1000 had PPV.
On day 1, LogMAR visual acuity was 0.754 ± 0.778 in the PnR group versus 2.565 ± 0.662 in the PPV group (p<0.001). At one week the PnR group had a LogMAR VA of 0.599 ± 0.657, while the PPV group had a LogMAR VA of 1.901 ± 0.957,(p< 0.001). LogMAR visual acuity at one month was 0.570 ± 0.681 in the PnR group and 0.717 ± 0.705 in the PPV group (P=0.023). At the three-month postoperative evaluation, LogMAR VA was 0.392 ± 0.474 in the PnR group compared to 0.443 ± 0.463 in the PPV group (p<0.001). At 6 months visual acuity was 0.369 ± 0.455 in the PnR group vs 0.448 ± 0.411 in the PPV group (p<0.001). At one year , patients treated with PnR had a LogMar VA of 0.344 ± 0.438 vs 0.286 ± 0.380 in those treated with PPV. P=0.2. The area Area Under the Curve visual acuity was 0.404 in the PnR group vs 0.518 in the PPV group which was statistically significant.
Conclusions :
Area under the curve visual acuity provides a longitudinal evaluation of a patient's overall outcome during the course of the study. This study demonstrates how patients undergoing PnR exhibit a faster recovery of visual acuity and have overall improved mean visual acuity over the course of the first year post-operatively.
.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.