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Size, duration of RD play significant role in PVR prevalence, severity

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Retinal detachment size and duration time, coupled with a poor initial visual acuity, play a significant role in a patient’s likelihood to develop proliferative vitreoretinopathy, according to a study.

Wendy Tseng and colleagues at Duke University analyzed data from 119 eyes of 119 patients who presented with rhegmatogenous retinal detachment in a private vitreoretinal clinic in Caracas, Venezuela, between 1995 and 1998. The authors noted that in developed countries, the prevalence of proliferative vitreoretinopathy (PVR) in eyes with rhegmatogenous retinal detachment (RD) ranges from 3.9% to 13.7% in eyes that have yet to undergo vitreoretinal surgery.

A detailed ophthalmologic history was obtained from each patient before surgery. Patient ages ranged from 5 to 83 years; almost 60% of the patients were men. Overall, 95 eyes had PVR, of which 32 had severe PVR. The average time of retinal detachment was 58.4 days. The main outcome measures were determining prevalence of PVR of any type, determining the preoperative risk factors for PVR of any type and for severe PVR, the effect of PVR and RD duration on initial and final visual acuity, as well as surgical complexity.

The significant risk factors identified in developing PVR of any type included the amount of time a patient had RD, the size of the RD, vitreous hemorrhage and poor initial visual acuity.

For patients with RD for less than 30 days, higher grades of PVR were rare. The longer a patient had an RD, the more likely he was to have severe PVR.

“The odds of having PVR for eyes with an RD duration of 40 days or more was 6 times greater than for eyes with an RD duration less than 40 days,” the researchers said in the June issue of American Journal of Ophthalmology. The odds of having PVR were 5.7 times greater for eyes with vitreous hemorrhage than for eyes without, they said. Eyes that had an initial visual acuity of 20/200 or worse were 3 times more likely to develop PVR than eyes with an initial visual acuity of 20/20.