Late Presentation of Retinal Detachment

Abstract

Purpose: To describe and evaluate demographic, clinical features, prognostic factors, and rate of success of surgery and visual outcomes in patients with late presentation of retinal detachment. Methods: A retrospective, comparative, observational case series of patients with late presentation retinal detachment, defined as retinal detachment with the loss of central vision for 4 weeks or more, over a period of 12 months. Results: The mean of onset of central visual loss was 12.7 weeks (SD, 21.3). Proliferative vitreoretinopathy at the first operation was identified in 69% of eyes. The overall primary success rate was 69.2%, significantly less than that was found in outcomes for nonselected retinal detachment (primary success rate, 86%; P = 0.006). The initial best-corrected visual acuity was 20/500, and the final was 20/160 (P = 0.0027). There were no identifiable statistically significant socioeconomic factors related to late presentation. Conclusion: A high rate of established proliferative vitreoretinopathy on presentation was identified, and although cases can be treated with good anatomical results, visual outcomes are often less favorable. Primary surgical success is lower, and more reoperations are required compared with standard retinal detachments.

Late Recurrence of Retinal Detachment: Incidence, Clinical Features and Surgical Outcomes

“…First, there was a high rate of establish PVR at the time of the late recurrence-38% of cases. PVR is known to significantly influence surgical outcomes, with primary success rates between 43% and 69% 3,4 when there is established PVR. Second, the inability to detect the retinal breaks intraoperatively has been associated with lower primary success rates of 70% to 80%.…”

“…T he primary anatomical surgical success rate of noncomplex rhegmatogenous retinal detachment (RRD) has been reported between 72% and 93%; 1,2 however, it is less in PVR-associated RRD-43% to 69%. 3,4 Vitrectomy is currently the most common surgical technique for repair accounting for 79% and 83% of the cases in the United Kingdom and the United States, respectively. 5,6 In most clinical trials and series, the overall primary success rate is reported with a limited period of follow-up making it difficult to establish whether this success rate is maintained over the time and leaving open the questions of long-term success of retinal detachment surgery.…”

Causal factors for late presentation of retinal detachment

“…This is in contrast to late presentation retinal detachment, which has commonly been described in low-income countries and attributed to a lack of access to healthcare, rurality and cost [ 3 ]. Recently, we have identified that late presentation retinal detachment (LPRD) continues to occur in the UK [ 4 ].…”

“…We previously noted that LPRD does not appear to be related with socioeconomic or educational status [ 4 ]. Although cases can be treated with good anatomical results, there is a high incidence of proliferative vitreoretinopathy (PVR) and visual outcomes are often less favourable.…”

“…Although cases can be treated with good anatomical results, there is a high incidence of proliferative vitreoretinopathy (PVR) and visual outcomes are often less favourable. In addition, there is an increase in cost to patients and healthcare systems [ 2 , 4 ].…”