Effect of Symptom Duration until Surgery on First-Year Outcome in Pseudophakic Primary Rhegmatogenous Retinal Detachment

Enders, Philip; Schick, Tina; Kemper, Carolin; Schaub, Friederike; Fauser, Sascha

doi:10.1159/000455805

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…Hassan et al did not find an effect on postoperative visual acuity in the first 10 days of detachment, but did find a decrease in visual outcome 10 days after symptoms were reported 2 . Enders P et al reported poorer visual acuity after symptoms which lasted more than 30 days compared to a shorter symptom duration 3 . Other studies have defined days 5 or 10 after the onset of symptoms as important thresholds for adverse visual outcomes [4][5][6][7] .…”

Section: Discussionmentioning

confidence: 97%

“…In previous studies, many preoperative factors have been reported to be significantly correlated with visual outcome for patients with RRD. These factors include patient age, preoperative visual acuity, duration of macular detachment, extent of retinal detachment, height of macular detachment, location and size of the retinal break, and proliferative vitreoretinopathy 1 – 3 , 7 . After the advent of OCT, the integrity of the photoreceptor outer segment layer, external limiting membrane integrity, and height of retinal detachment at the central fovea were reported to be correlated with postoperative BCVA 8 – 11 .…”

Section: Discussionmentioning

confidence: 99%

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Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

Yeo

Kim

2020

Sci Rep

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Rhegmatogenous retinal detachment (RRD) is a vision-threatening pathology. Optical coherence tomography (OCT) is useful for evaluating retinal damage and visual prognosis in patients with RRD. Outer retinal undulation (ORU) is often observed on preoperative OCT in RRD. Therefore, we evaluated the correlation between ORU seen on preoperative OCT and pre/post-operative factors in RRD. Patients with RRD (114 eyes) underwent reattachment surgery and ≥ 6 months of follow-up. According to the condition of the macula on preoperative OCT, cases were divided into macula-on RRD (65 eyes) or macula-off RRD (49 eyes). Patients were classified into acute (< 10 days), subacute (10–30 days), and chronic (> 30 days) symptom duration groups. Clinical findings, histories, and relationships with OCT findings, including ORU, were analyzed. Subacute symptom duration was significantly associated with ORU on preoperative OCT (p = 0.001) and had a higher prevalence of ORU (73.7%) than did acute (OR = 4.48) or chronic (OR = 7.467) durations. Ellipsoid zone (EZ) disruption was significantly associated with poorer best-corrected visual acuity (BCVA) than normal EZ integrity at 6 months postoperatively (p = 0.012). ORU on preoperative OCT suggests a 10–30 days morbidity duration in RRD. EZ integrity is useful for predicting postoperative BCVA in macula-off RRD.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

Yeo

Kim

2020

Sci Rep

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“…However, in some cases, reparative surgery still fails. Previous studies have reported that a range of risk factors are associated with the recurrence of detachment, including: proliferative vitreoretinopathy (PVR) [2], inferior breaks [3], the duration of symptoms [4], and the extent of detachment [5]. However, little is known about the relationships between specific risk factors and RRD.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Fu¹,

Xie²,

Gu³

et al. 2020

Preprint

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Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.

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“…RRD progression to foveal detachment and the duration of the foveal detachment directly affect visual acuity (VA) outcome. [3][4][5][6] Whether patient travel distance affects RRD presentation and outcome has not been extensively studied. In Scotland, the geographic area served was a significant risk factor for presentation of fovea-off RRD.…”

Section: Introductionmentioning

confidence: 99%

“…RRD progression to foveal detachment and the duration of the foveal detachment directly affect visual acuity (VA) outcome. 3 –6…”

Section: Introductionmentioning

confidence: 99%

Impact of Long-Distance Travel on Rhegmatogenous Retinal Detachment Presentation and Outcome in Rural North Dakota

Jacobs

Gokey

Beal

2019

Journal of VitreoRetinal Diseases

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Purpose: Long-distance travel in underserved, rural areas could delay treatment of rhegmatogenous retinal detachment (RRD). The purpose of this study was to determine whether patients living remotely experienced a delay in treatment, presented with more-advanced RRD, or had worse visual acuity (VA) outcomes than patients living locally. Methods: A retrospective consecutive case series is presented of patients undergoing RRD repair by pars plana vitrectomy or scleral buckle from August 2011 to September 2014 in Minot, North Dakota, USA. Exclusion criteria were RRD cases presenting with concurrent vitreoretinal disease. Results: Of the 143 total patients, 45 lived locally, 5.2±1.6 miles (8.4±2.6 km), and 98 lived remotely, 122.8±69 miles (197.6±111 km). Duration of symptoms was 14.0±30.2 days for local and 19.2±37.5 days for remote patients ( P = .42). Time from referring provider exam to vitreoretinal surgeon exam was similar for local and remote patients, 1.5±2.9 vs 1.5±2.8 days ( P = .97). The fovea was detached in 51.1% of local and 53.6% of remote patients ( P = .78). Mean clock-hours of RRD were similar in local and remote patients, 5.2±2.3 vs 5.5±2.6 hours ( P = .51). Proliferative vitreoretinopathy was present in 6.7% of local vs 14.4% of remote patients ( P = .19). Time from vitreoretinal surgeon exam to surgical repair was similar for local and remote patients, 1.8±3.4 vs 1.8±3.8 days ( P = .70). The mean logMAR VA change at 6 months was similar in local and remote patients, –0.54±.7 vs –0.52±.8 ( P = .91). Reoperation was required in 4.4% of local vs 6.1% of remote patients ( P = .69). Conclusions: Patients traveling long distances for management of RRD did not experience a significant delay in treatment, present with more-advanced RRD, or have worse VA outcomes than patients who lived locally. Patients with RRD living in remote rural areas can have similar outcomes to patients living locally when referred and treated urgently.

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Effect of Symptom Duration until Surgery on First-Year Outcome in Pseudophakic Primary Rhegmatogenous Retinal Detachment

Cited by 12 publications

References 16 publications

Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Impact of Long-Distance Travel on Rhegmatogenous Retinal Detachment Presentation and Outcome in Rural North Dakota

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