Prognostic Factor Analysis of Visual Outcome after Vitrectomy for Rhegmatogenous Retinal Detachment.

Polona Zaletel Benda,Ana Gornik,Ana Uršula Gavrić,Katja Matović,Xhevat Lumi,Anila Lumi,Katarina Vergot,Goran Petrovski,Bor Vratanar

doi:10.3390/jcm9103251

Abstract

Pars plana vitrectomy (PPV) is a surgical approach mainly chosen for complex rhegmatogenous retinal detachment (RRD) repair with highly variable functional results. The aim of this analysis was to evaluate the impact of preoperative factors and postoperative optical coherence tomography (OCT) macular findings on the functional outcome of patients undergoing primary PPV for RRD. A retrospective analysis was performed on 88 eyes of 88 patients with complex RRD managed by PPV. A swept source OCT was used to obtain images at the postoperative visit at least 6 months after PPV. Hierarchical linear regression model was used to evaluate the influence of preoperative factors related to patient, ocular clinical and postoperative OCT macular findings on functional outcomes of PPV for RRD. Duration of symptoms (p = 0.031) and discontinuity of the ellipsoid zone (EZ) on OCT (p = 0.024) showed statistically significant negative correlation, while preoperative best-corrected visual acuity (BCVA; p < 0.001) showed statistically significant positive correlation to postoperative BCVA. Preoperative BCVA and duration of symptoms can be used as prognostic factors for visual outcome in patients undergoing PPV for RRD. Discontinuity of the EZ was the only postoperative OCT variable related to worse postoperative visual outcome.

Highlights

Rhegmatogenous retinal detachment (RRD) is a potentially vision-threatening retinal disorder with an approximate annual incidence of 12 per 100,000 people [1]
Pneumatic retinopexy and scleral buckling surgery are the methods of choice for simple rhegmatogenous retinal detachment (RRD), while Pars plana vitrectomy (PPV) is more widely used for complex RRD [4]
A total of 88 eyes of 88 patients characterized by male predominance (60 males, 28 females; sex ratio: 2.1) who underwent PPV for RRD were enrolled in this study

Summary

Introduction

Rhegmatogenous retinal detachment (RRD) is a potentially vision-threatening retinal disorder with an approximate annual incidence of 12 per 100,000 people [1]. Standard surgical treatment options for retinal detachment are pneumatic retinopexy, scleral buckling and pars plana vitrectomy (PPV) [3]. Pneumatic retinopexy and scleral buckling surgery are the methods of choice for simple RRD, while PPV is more widely used for complex RRD [4]. In simple RRD, the detachment is localized to a single, small retinal tear or hole at the retinal periphery accompanied by good visibility of the fundus [5]. In complex RRD, the detachment is partial, subtotal or total with multiple retinal breaks, posterior breaks, retinal dialysis or a giant tear. It can be associated with vitreous hemorrhage, ocular trauma and proliferative vitreoretinopathy (PVR) [5,6]

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Results

Conclusion