Factors Associated With Good Visual Acuity Outcomes After Retinectomy in Eyes With Proliferative Vitreoretinopathy.

Autor: Israilevich RN; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Starr MR; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Mahmoudzadeh R; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Salabati M; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Swaminathan V; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Huang D; UC Davis Eye Center, Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, CA, USA., Kuriyan AE; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Yonekawa Y; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Garg SJ; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Mehta S; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Regillo CD; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H)., Hsu J; From The Retina Service of Wills Eye Hospital, Mid Atlantic Retina (M.R.S, R.M, M.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (R.N.I, V.S, A.E.K, Y.Y, S.J.G, S.M, C.D.R, J.H). Electronic address: jhsu@midatlanticretina.com.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2022 Aug; Vol. 240, pp. 143-148. Date of Electronic Publication: 2022 Mar 12.
DOI: 10.1016/j.ajo.2022.02.028
Abstrakt: Purpose: To investigate factors associated with good visual acuity (VA) following repair of rhegmatogenous retinal detachments (RD) with proliferative vitreoretinopathy (PVR) undergoing retinectomy.
Design: Interventional, retrospective, case-control study.
Methods: This single-institution study evaluated patients who underwent retinectomy during repair of RD with PVR from January 1, 2015 to December 31, 2019. A good VA cohort was identified based on a final VA ≥20/70. A 2:1 age-matched and gender-matched poor VA cohort with VA <20/70 was subsequently identified. Metrics compared between the two cohorts included time from primary and recurrent RD diagnosis to surgery, lens status, initial RD size, macula involvement, PVR grade, and size of retinectomy.
Results: A total of 5355 eyes were diagnosed with primary RD during the study period, of which 345 had PVR and underwent retinectomy. The good VA cohort included 62 eyes with a mean final logMAR VA of 0.32 [Snellen 20/42], while the poor VA cohort included 119 eyes with a mean final logMAR VA of 1.54 [Snellen 20/693; P < .0001]. On multivariate analysis, smaller initial RD size (P = .0090), fewer surgeries (P = .0002), shorter time between recurrent RD diagnosis and subsequent surgeries (P = .0006), better preoperative VA (P = .0276), and pseudophakia at final visit (P = .0049) remained significant predictors of good vision.
Conclusion: Eyes undergoing retinectomy during repair of RD with PVR can achieve good VA outcomes. The primary modifiable factor associated with better VA was shorter delay between redetachment diagnosis and surgery, particularly in the absence of silicone oil tamponade.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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