Follow-up important in patients with acute posterior vitreous detachment
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PHILADELPHIA — Delayed retinal breaks and retinal detachments occur more often after acute posterior vitreous detachment in patients with underlying risk factors, according to a study presented at Wills Eye Conference.
“Retinal breaks may progress to retinal detachment in 30% to 50% of untreated eyes,” Joshua H. Uhr, MD, said. “The literature on delayed break after PVD is limited in existing studies ... and there are conflicting recommendations in the literature regarding the need for follow-up.”
In a study to determine incidence, timing and risk factors for breaks and detachments, patients presenting for an initial visit to the Wills Eye Retina Service or Mid Atlantic Retina over a 3-year period with a diagnosis code of posterior vitreous detachment (PVD) and a procedure code for extended ophthalmoscopy were included. Of those patients, 7,999 eyes with acute PVD were compared with a reference group of 100 eyes.
The study found 1,280 eyes (16%) had a retinal break on the first exam, while delayed retinal breaks were found in 209 eyes (2.6%). Retinal detachments were found in 499 eyes (6.2%) on the initial visit, and 80 eyes (1%) had delayed retinal breaks.
Vitreous hemorrhage and male gender were risk factors for both breaks and detachments, while pseudophakia was as a risk factor for detachment.
Of these outcomes, 44.5% of breaks and 67.5% of detachments were found 6 weeks after presentation, which challenges the assumption that retinal breaks do not develop after 6 weeks, according to Uhr.
“Our findings emphasize the importance of follow-up with patients who present with PVD in order to mitigate the cost and morbidity associated with retinal detachment,” Uhr said. “It is particularly important to follow up with patients with risk factors on the first exam.”– by Kate Burba
Reference:
Uhr JH, et al. Delayed retinal breaks and detachments after acute posterior vitreous detachment. Presented at: Wills Eye Conference; March 5-7, 2020; Philadelphia.
Disclosure: Uhr reports no relevant financial disclosures.