Original article
Prevalence and risk factors for proliferative vitreoretinopathy in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery

https://doi.org/10.1016/j.ajo.2004.02.008Get rights and content

Abstract

Purpose

To determine the prevalence of and risk factors for proliferatative vitreoretinopathy (PVR) in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery.

Design

Observational case series.

Methods

Prospective study.

Setting

A private vitreoretinal clinic in Caracas, Venezuela.

Study population

119 eyes of 119 patients who presented with rhegmatogenous retinal detachment but no previous vitreoretinal surgery between 1995 and 1998.

Observation procedures

Data from detailed preoperative and postoperative examinations of each eye were recorded prospectively and entered into an electronic database.

Main outcome measures

Prevalence of PVR of any type and severe PVR, preoperative risk factors for PVR of any type and severe PVR, effect of PVR and retinal detachment duration on initial and final visual acuity, and surgical complexity.

Results

The prevalence of PVR of any type was 52.9% and of severe PVR was 26.9%. The mean retinal detachment duration (±SD) was 58.4 (±129.1) days, and the mean time from initial examination to surgical treatment (±SD) was 24.3 (81.2) days. By univariable analysis, long retinal detachment duration, poor initial visual acuity, and large retinal detachment extent were significantly associated with PVR prevalence and severity. The presence of vitreous hemorrhage was significantly associated with PVR prevalence, and cataract was significantly associated with PVR severity. By multivariable analysis, long retinal detachment duration and large retinal detachment extent were simultaneous risk factors for PVR prevalence, while long retinal detachment, large retinal detachment extent, and poor initial visual acuity were simultaneous risk factors for PVR severity. Eyes with longer retinal detachment duration, PVR of any type, and severe PVR had worse initial and final visual acuities than eyes with shorter retinal detachment duration or those without PVR, respectively. Eyes with PVR had more complex surgery than those without PVR.

Conclusions

PVR occurred very frequently in this population and was associated with more complex surgery and worse visual outcomes than among eyes without PVR. We have identified preventable risk factors associated with PVR that suggest a specific and significant need for better access to ophthalmologic care and patient education in this group of patients.

Section snippets

Design

Observational case series.

Setting

This study was conducted in one author's (R.T.C.) private vitreoretinal subspecialty clinic at the Centro de Cirugı́a Oftalmológica in Caracas, Venezuela.

Study population

We studied a series of 119 patients (119 eyes) who presented with rhegmatogenous RD between 1995 and 1998.

Observation procedures

The Duke University Institutional Review Board approved this investigation. Each patient underwent a preoperative examination that included a detailed ophthalmologic history. Ocular examination included a measurement of best-corrected

Results

A total of 119 patients were studied. The mean patient age (±SD) was 53.4 ± 14.6 years and ranged from 5 to 83 years. Of the 119 patients, 71 (59.7%) were men. Overall, 63 eyes (52.9%) had PVR; 32 (26.9%) had grade C PVR. The mean RD duration (±SD) was 58.4 ± 129.1 days, and the mean time from initial examination to surgical treatment (±SD) was 24.3 ± 81.2 days.

The results of the univariable analyses of variables associated with prevalence of PVR are shown in TABLE 1, TABLE 2, TABLE 3. The

Discussion

Proliferative vitreoretinopathy was highly prevalent in our study population. From our univariable modeling, we found that long RD duration, poor initial visual acuity, and large RD extent were significantly associated with PVR prevalence and severity. The presence of vitreous hemorrhage was significantly associated with PVR prevalence, and the presence of cataract was significantly associated with PVR severity. Of these factors, long RD duration and large RD extent were simultaneously

Supplementary files

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