Fellow-Eye Retinal Detachment Risk as Stratified by Hyaloid Status on OCT

Abstract

To evaluate the risk of a rhegmatogenous retinal detachment (RRD) in the fellow eye utilizing posterior hyaloid status as determined by optical coherence tomography (OCT) at the time of initial RRD. Retrospective chart review. Patients diagnosed with an RRD. Posterior hyaloid status-presence or absence of a posterior vitreous detachment-in both eyes at the time of initial RRD was determined by OCT imaging. Baseline characteristics including lattice degeneration, refractive error, prior ocular laser procedures, lens status and family history of RRD. Development of fellow eye RRD along with time to fellow eye RRD. In addition, OCT imaging was utilized in those fellow eyes with a visible posterior hyaloid to document whether a posterior vitreous detachment (PVD) developed during follow-up and time to such an event. A total of 1049 patients with an RRD were followed for an average of 5.7 ± 0.3 years. Overall, 153 (14.6%) patients were diagnosed with bilateral sequential RRDs during this follow-up period. There were OCT images available for 582 fellow eyes: PVD noted in 229 (39.3%) and an attached hyaloid in 353 (51.7%) fellow eyes. An RRD occurred in 7 (3.1%) fellow eyes with a PVD at presentation. Within the cohort of fellow eyes with an attached hyaloid, 29 (8.2%) developed an RRD during follow-up; however, when evaluating only those that developed a PVD during follow-up 24.6% of such eyes were found to have an RRD as well. At the time of PVD development in the fellow eye an additional 21 (17.8%) eyes were noted to have a retinal tear that was treated without progression to RRD. Optical coherence tomography imaging of the fellow eye at time of presentation with an RRD offers a significant amount of information regarding risk stratification for RRD in this eye. Patients noted to have a completely detached posterior hyaloid are at a significantly lower risk of RRD than those with a visible posterior hyaloid-who need to be monitored closely at the time of PVD development.