Outcomes and Complications Associated with Noninfectious Uveitis in Patients Presenting with Rhegmatogenous Retinal Detachment

Abstract

To evaluate the visual outcomes and complications associated with noninfectious uveitis in patients presenting with a rhegmatogenous retinal detachment (RRD). Retrospective cohort study. A total of 554 eyes of 523 patients presenting for RRD repair at the Department of Ophthalmology, University of Colorado School of Medicine, between July 2011 and September2016. Analysis of risk factors, anatomic outcomes, and visual outcomes related to a history of noninfectious uveitis. End point rate of reattachment, end point visual acuity (VA), postoperative proliferative vitreoretinopathy (PVR), and rate of reoperation. A history of uveitis was identified in 5.4% of eyes. Eyes with a history of uveitis were found to have a higher risk for development of any degree of PVR (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1-4.4, P= 0.030) and a higher risk of PVR necessitating an additional procedure (HR, 2.7; 95% CI, 1.2-6.0, P= 0.014). Anatomic and visual outcomes did not differ between the 2 groups. Preoperative VA, the distribution of race/ethnicity, age, gender, lens status, macula status, and lattice degeneration status did not vary significantly between the groups. In the analysis of a PVR subgroup, uveitis was not associated with a higher risk of PVR necessitating an additional procedure and did not show a statistically significant difference in end point VA. A history of uveitis is associated with an increased risk of any degree of PVR and an increased risk of PVR necessitating an additional procedure. However, subgroup analysis suggests that patients with a history of uveitis who develop PVR do not necessarily have a worse visual outcome or a higher risk of additional surgery. There may be a role for perioperative steroids in patients with a history of uveitis who present with a retinal detachment, but further study is warranted to determine if this decreases the risk of PVR or improves visual outcomes.