Anatomic Outcomes and Prognostic Factors of Vitrectomy in Patients with Primary Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

Yu, Yaoxiang; Yue, Yankun; Tong, Nianting; Zheng, Pengfei; Liu, Wu; An, Ming

doi:10.1080/02713683.2018.1540705

Cited by 17 publications

(36 citation statements)

References 19 publications

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“…One quarter of our eyes with relatively extensive, ie, macula-involving RD that received primary SF 6 gas filling (23 out of 90 eyes), developed re-detachment (group 1 patients). The retinal reattachment rate in eyes receiving primary SF 6 gas filling was thus 74.4%, which is well in line with a recent meta-analysis reporting a primary success rate between 72% and 79% 9 and a recently published study 33 with a reattachment rate of 72.6% after primary surgery. Although the study cohorts were relatively small, both groups were well comparable regarding baseline characteristics as well as visual and anatomic outcomes and showed similarities to previously published studies.…”

Section: Discussionsupporting

confidence: 89%

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

Deiss

Kaya²,

Pfister³

et al. 2020

OPTH

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Background To compare visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling and failed SF 6 gas tamponade requiring silicone oil (SO) in a second procedure with primary SO tamponade in fovea-involving retinal detachment (FiRD). Methods Retrospective analysis of 82 eyes with retinal detachment and mild, but without advanced proliferative retinopathy (PVR ≥C2) requiring vitrectomy for FiRD. Group 1 comprised 23 eyes that underwent SF 6 tamponade resulting in re-detachment requiring revision surgery with secondary SO tamponade. Based on the intraoperative findings, group 2 patients had primarily received SO as vitreal tamponade (n=59). Patients receiving a scleral buckle surgery or with advanced PVR as well as patients with underlying vascular diseases and uveitis were excluded. Results Preoperative visual acuity (Early Treatment Diabetic Retinopathy Study letters) was 13.5 ± 19.1 in group 1 and 14.0 ± 18.3 in group 2 ( p =0.44). Twelve months after first surgery for FiRD, visual acuity was 49.8 ± 19.8 in group 1 and 51.7 ± 18.7 letters in group 2 ( p= 0.63). Re-detachment after SO removal requiring revision surgery developed in 17.4 (n=4) and 15.3% (n=9) cases. Conclusion Our findings suggest that if retinal traction is completely relieved at the end of surgery, vitrectomy with ILM peeling and SF 6 may, if successful, improve the functional outcomes in instances with visual potential, ie, a foveal detachment of short duration despite the presence of a mild to moderate PVR, but with the inherent increased risk of re-detachment requiring further intervention and the use of a SO tamponade. Hence, secondary SO installation during re-vitrectomy after failed primary reattachment surgery results in similar functional outcomes as primary oil filling.

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Section: Discussionsupporting

confidence: 89%

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

Deiss

Kaya²,

Pfister³

et al. 2020

OPTH

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“…We had a much higher prevalence of RRD-CD in our group of patients at 34.2%. The prevalence of PVR C-D is higher in RRD-CD patients at 28 [24]-66.9% [25] compared to RRD patients in previous reports. PVR progression was found in 16 RRD-CD patients.…”

Section: Discussionmentioning

confidence: 48%

The Risk Factors of the Progression of Rhegmatogenous Retinal Detachment on Patients with the Fourteen-day Quarantine in the Early Period of COVID-19 Outbreak

Zhao

She

et al. 2021

Preprint

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Backgrounds: The COVID-19 pandemic has great impact on hospitals and patients. The fourteen-day quarantine caused surgery of RRD postponed. To explore the risk factors of rhegmatogenous retinal detachment (RRD) progression in a group of patients whose surgery was postponed during the top-level emergency response of COVID-19.Methods: Retrospective case series study. The information on RRD patients who received surgeries in Beijing Tongren Hospital's retina service from February 16, 2020, to April 30, 2020 has been collected retrospectively. The history, manifestation on presentation and admission, and progression of RRD were recorded. RRD progression was defined as the presence of either choroidal detachment (CD) or proliferative vitreoretinopathy (PVR) progression during the quarantine period. Risk factors were analyzed using the Cox proportional hazards model, survival analysis, and logistic regression.Results: There were 79 cases enrolled in this study. The median time from the patients' presentation at the clinic to admission for surgery was 14 days (3–61 days). There were 70 cases (88.6%) who did not present to the hospital within one week of the onset of visual symptoms. There were 69 (87.3%) macular-off cases at the presentation. There were 27 (34.2%) cases combined with choroidal detachment. There were 49 (62.0%) cases with PVR B, 22 (27.8%) cases with PVR C, 4 (5.1%) cases with PVR D, and 4 (5.1%) cases with PVR A. After the 14-day quarantine, 21 (26.6%) cases showed RRD progression, and 9 cases showed RD regression at the time of surgery. Neither the time of onset of the visual symptom (p=0.46) nor the time between presentation and admission (p=0.31) was significantly different between the patients with RRD progression and patients without RRD progression. The combination of CD (3.61, 1.86-6.99, p=0.001) and retinal breaks located posterior to the equator (3.78, 1.25-11.45, p=0.02) were factors related to the progression of RRD. Conclusions: In the cases enrolled in our study during the COVID-19 outbreak period, the RRD progression risk factors included a combination of CD and retinal breaks posterior to the equator. Ophthalmologists should schedule the surgeries for RRD patients with these signs as soon as possible.

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“…Their main characteristics and results are shown in Table 1. Four had a prospective design but only two of these were randomized; the other three of the seven studies were retrospective [27][28][29][30][31][32]. Our systematic review found that CCS are widely used preoperatively in addition to surgery to treat patients affected by RRD associated with choroidal detachment (CD) [27][28][29][30][31][32].…”

Section: Preoperative Usementioning

confidence: 99%

“…According to these pathogenic theories, the pre-operative use of CCS could play an important role in preparing patients affected by RRDCD for surgery, in order to increase IOP and reduce CD by reducing the permeability of choroidal blood vessels, inhibiting inflammatory reactions and cellular proliferation, and stabilizing BRB [27][28][29][30][31][32].…”

Section: Preoperative Usementioning

confidence: 99%

Preoperative, Intraoperative and Postoperative Corticosteroid Use as an Adjunctive Treatment for Rhegmatogenous Retinal Detachment

Bonfiglio

Reibaldi

Macchi

et al. 2020

JCM

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The treatment for rhegmatogenous retinal detachment (RRD) is surgery, including pars plana vitrectomy (PPV) and scleral buckling (SB). Despite surgical advances, degeneration of the photoreceptors and post-operative complications, such as proliferative vitreoretinopathy (PVR), often occurs as the result of inflammation, preventing complete visual recovery or causing RRD recurrence. There is increasing evidence that in the presence of RRD, the activation of inflammatory processes occurs and the surgery itself induces an inflammatory response. This comprehensive review focuses on the use of different formulations of corticosteroids (CCS), as an adjunctive treatment to surgery, either PPV or SB, for RRD repair. The purpose was to review the efficacy and safety of CCS in improving functional and anatomical outcomes and in preventing postoperative complications. This review is organized according to the timing of CCS administration: preoperative, intraoperative, and postoperative. The evidence reviewed supported the role of the pre-operative use of CCS in the treatment of combined RRD and choroidal detachment (CD), reducing CD height. No solid consensus exists on intraoperative and postoperative use of CCS to treat and prevent postoperative complications. However, a large randomized clinical trial including more than 200 eyes suggested that oral prednisone after surgery decreases the rate of postoperative grade B PVR.

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Anatomic Outcomes and Prognostic Factors of Vitrectomy in Patients with Primary Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

Cited by 17 publications

References 19 publications

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

The Risk Factors of the Progression of Rhegmatogenous Retinal Detachment on Patients with the Fourteen-day Quarantine in the Early Period of COVID-19 Outbreak

Preoperative, Intraoperative and Postoperative Corticosteroid Use as an Adjunctive Treatment for Rhegmatogenous Retinal Detachment

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