Association between laser flare photometry and symptom duration in primary rhegmatogenous retinal detachment

Abstract

Purpose The purpose of this study was to investigate preoperative blood-ocular barrier disruption via laser flare photometry (LFP) in patients diagnosed with rhegmatogenous retinal detachment (RRD), and to analyse possible associations with symptom duration and anatomical parameters. Methods We retrospectively analysed consecutive patients presenting with RRD at a single centre between January 2016 and March 2020. LFP was performed in both eyes after pupillary dilatation prior to RRD surgery. Symptom duration, extent of retinal detachment, and lens status were assessed. For statistical analysis, we carried out the unequal variances t test and Welch’s analysis of variance (ANOVA). Results We included 373 eyes of 373 patients (mean age 63.96 years ± 10.29; female:male ratio 1:1.8). LFP values quantified in photon count per millisecond (pc/ms) increased with longer symptom duration when comparing patients with a symptom duration of 0–3 days (n = 158; 9.25 ± 6.21 pc/ms) and ≥ 4 days (n = 215; 11.97 ± 11.58 pc/ms; p = 0.004). LFP values also rose with the number of retinal quadrants affected by RRD (1 quadrant, 6.82 ± 4.08 pc/ms; 2 quadrants, 10.08 ± 7.28 pc/ms; 3 quadrants, 12.79 ± 7.9 pc/ms; 4 quadrants, 31.57 ± 21.27 pc/ms; p < 0.001), macula off status (macula on, 8.89 ± 6.75 pc/ms; macula off, 12.65 ± 11.66 pc/ms; p < 0.001), and pseudophakic lens status (pseudophakia, 12.86 ± 9.52 pc/ms; phakia: 9.31 ± 9.67 pc/ms; p < 0.001). Conclusion In RRD patients, blood-ocular barrier disruption quantified by LFP is associated with the duration of symptoms and the disease’s anatomical extent. These results warrant further investigation of the potential clinical use of LFP in RRD.

Laser Flare Photometry in Primary Rhegmatogenous Retinal Detachment: an Evaluation of 2487 Cases

“…We have published this finding before in a smaller scale. 25 Pseudophakia also seems to impair the bloodaqueous barrier because of increased permeability of the lens-iris diaphragm, which may cause elevated flare values compared with phakic eyes. 26 To our knowledge, this is the first study to show an influence of sex on laser flare.…”

Relevanz der Laser-Flare-Photometrie bei retinalen Pathologien

“…Eyes with extended periods of RRD and higher laser flare values show increased levels of inflamma-tion with the infiltration of activated macrophages over time, and there is an increased risk of PVR formation [46]. Interestingly, significantly higher flare values were measured in pseudophakic eyes compared to phakic eyes [43,44,47]. This may be explained by the easier perfusion from the posterior to the anterior chamber of the eye in pseudophakia.…”

“…Augen mit längerer Dauer der RRD und höheren Laser-Flare-Werten weisen im Laufe der Zeit eine Zunahme der Entzündung mit Infiltration von aktivierten Makrophagen auf, und es kommt zu einem erhöhten Risiko für PVR-Bildung 46 . Interessanterweise wurden in den Untersuchungen bei pseudophaken Augen ebenfalls signifikant höhere Flare-Werte gemessen im Vergleich zu phaken Augen 43 , 44 , 47 . Eine Vermutung ist die erleichterte Perfusion von der hinteren zur vorderen Augenkammer bei Pseudophakie.…”

“…Eine längere Symptomdauer bei Augen mit primärer rhegmatogener Netzhautablösung (RRD), insbesondere in der 1. Woche, führt zu einem Anstieg der Laser-Flare-Werte [44]. Dieser Aspekt ist am ehesten durch die anhaltende Störung der Kammerwasserschranke zu erklären [45].…”

“…How long patients exhibited symptoms was also examined in more detail. In cases where symptoms persisted for longer periods of time in eyes with primary rhegmatogenous retinal detachment (RRD), especially in the first week, laser flare values increased [44]. This aspect can best be explained by the persistent impairment of the aqueous humor barrier [45].…”