Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment

Shah, Yesha S.; Abidi, Muhammad; Ahmed, Ishrat; Arsiwala-Scheppach, Lubaina T.; Ong, Sally S.; Wu, David; Handa, James T.

doi:10.1016/j.oret.2023.11.013

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…This is the same cohort studied in prior publications by our group, and details of patient identification have been previously described. 4,17 For patients who had 2 qualifying eyes, the eye with the worse visual acuity was chosen. If both eyes had the same visual acuity, 1 eye was chosen at random.…”

Section: Patientsmentioning

confidence: 99%

Neighborhood-Level Social Determinants of Health and Presenting Characteristics for Rhegmatogenous Retinal Detachments

Ong,

Tran,

Westlund

et al. 2024

JAMA Ophthalmol

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ImportanceFunctional outcomes after repair of rhegmatogenous retinal detachments (RRDs) are highly dependent on baseline visual acuity and foveal status. Adverse social determinants of health (SDOH) can present barriers to timely presentation for repair and limit vision outcomes.ObjectiveTo evaluate the association between neighborhood-level SDOH with baseline severity (visual acuity and fovea status) of RRD.Design, Setting, and ParticipantsThis was a retrospective cohort study that included adult patients 18 years and older who underwent primary repair of uncomplicated RRD at the Wilmer Eye Institute from January 2008 to December 2018. Study data were analyzed from December 2023 to April 2024.ExposuresThe census block group of patient home addresses were matched to multiple neighborhood-level SDOH including the Area Deprivation Index (ADI), per capita income, percentage of renters, percentage of rent burden, percentage of people using a food assistance program, percentage of uninsured individuals, mode of transportation to work, distance to the nearest transit stop, total road density, National Walkability Index, Index of Medical Underservice score, and aggregate cost of medical care.Main Outcomes and MeasuresOdds of presenting with vision worse than 20/40 or fovea-involving RRD using multivariable logistic regression adjusting for age, sex, race and ethnicity, and insurance.ResultsA total of 700 patients (mean [SD] age, 57.9 [12.4] years; 432 male [61.7%]) were included. Every decile increase in ADI, indicating more socioeconomic disadvantage, was associated with an increased odds of presenting with worse visual acuity and fovea-involving RRD (odds ratio [OR], 1.14; 95% CI, 1.04-1.24; P = .004 and OR, 1.13; 95% CI, 1.04-1.22; P = .005, respectively). Each $1000 increase in per capita income was associated with lower odds of presenting with worse vision (OR, 0.99; 95% CI, 0.98-0.99; P = .001). Every 1% increase in percentage of workers who drove to work was associated with an increased odds of presenting with worse vision and fovea-involving RRD (OR, 1.02; 95% CI, 1.01-1.03; P = .005 and OR, 1.01; 95% CI, 1.00-1.03; P = .04, respectively).Conclusions and RelevanceResults of this cohort study suggest that patients with a residence in neighborhoods with more socioeconomic deprivation or a higher percentage of workers who drove to work were more likely to present with more severe RRD even after accounting for multiple individual-level characteristics. These findings support consideration of public policy changes to address the barriers faced by patients residing in certain neighborhoods who seek prompt surgical intervention for RRD to reduce health disparities in RRD outcomes.

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Section: Patientsmentioning

confidence: 99%

Neighborhood-Level Social Determinants of Health and Presenting Characteristics for Rhegmatogenous Retinal Detachments

Ong,

Tran,

Westlund

et al. 2024

JAMA Ophthalmol

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Macular edema after rhegmatogenous retinal detachment: can we treat it effectively?

Ferro Desideri,

Arun,

Melo

et al. 2024

Expert Review of Ophthalmology

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Factors affecting the development of cystoid macular edema following pars plana vitrectomy with silicone oil placement: a retrospective cohort study

ElSheikh,

Zhang,

Chauhan

et al. 2024

Int J Retin Vitr

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Background Cystoid macular edema (CME) can develop following silicone oil placement in complex vitreoretinal surgeries, contributing to poor visual outcomes. In this study, we investigated the clinical and surgical characteristics associated with the development of CME following the use of silicone oil (SO) in pars plana vitrectomy (PPV) surgeries. Methods We conducted a retrospective chart review of patients who underwent implantation of SO during PPV from 2010 to 2020 by a single surgeon. Patient demographics, type of oil, duration of oil tamponade, retinectomy size, diabetic status, lens status, prior panretinal photocoagulation, visual acuity, and incidence of CME were reviewed. Results This study included 43 eyes from 40 patients who underwent SO tamponade for retinal detachment (RD) surgery. The mean duration of SO tamponade was 15.7 ± 12.7 months (range: 1–58 months). The most common indication for surgery was diabetic tractional RD (32.7%), followed by traumatic RD (16.3%) and rhegmatogenous RD with proliferative vitreoretinopathy (11.6%). Of the 43 eyes, 18 (41.9%) developed CME for the first time after PPV with SO placement, with 8 (44%) resolving within a year of oil removal. The mean duration for the development of CME was 9 months. A logistic regression model showed that a scleral buckle procedure and poor initial vision were statistically significant factors for predicting the development of CME (ORs: 11.65 and 16.06, respectively). Overall, 91% of the patients had stable or improved vision after surgery. Conclusions The use of a scleral buckle procedure and poor initial vision are significant factors for predicting CME following silicone oil tamponade in PPV surgeries, with 41.9% of patients developing CME with an average duration of 9 months. Recognizing such factors can lead to early monitoring and prompt management of CME. Meeting presentation Partial analyses were presented at the ASRS 2020 conference. Clinical trial number Not applicable.

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Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment

Cited by 3 publications

References 30 publications

Neighborhood-Level Social Determinants of Health and Presenting Characteristics for Rhegmatogenous Retinal Detachments

Neighborhood-Level Social Determinants of Health and Presenting Characteristics for Rhegmatogenous Retinal Detachments

Macular edema after rhegmatogenous retinal detachment: can we treat it effectively?

Factors affecting the development of cystoid macular edema following pars plana vitrectomy with silicone oil placement: a retrospective cohort study

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