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    Review of: Delayed Retinal Breaks and Detachments after Acute Posterior Vitreous Detachment

    Uhr J, Obeid A, Wibbelsman T, et al. Ophthalmology, April 2020

    Researchers assessed the rate of delayed retinal breaks and retinal detachments (RDs) occurring after acute posterior vitreous detachment (PVD).

    Study design

    This retrospective, case-control study examined 7,999 eyes with acute PVD at a single academic retina practice during a 3-year period. The authors investigated the incidence of delayed retinal break or detachment, defined as a new break/RD noted on any follow-up exam. Duration between the initial and treatment visit was measured as well as possible predictive risk factors.

    Outcomes

    At presentation, 1,280 (16%) of eyes had a retinal break and 499 (6.2%) had RD. During follow-up, 209 eyes (2.6%) developed a delayed retinal break and 80 (1%) developed a new retinal detachment. Approximately half of delayed breaks and 68% of delayed RDs occurred more than 6 weeks after the initial exam. Vitreous hemorrhage and male gender were significant risk factors for delayed breaks and RD. Pseudophakia correlated with delayed RD while older age was slightly protective.

    Limitations

    The findings are limited by the study’s retrospective nature. Only 4,472 (56%) of eyes had more than 6 weeks of follow-up.

    Clinical significance

    Repeat examination in eyes presenting with acute PVD can be important for identifying delayed retinal breaks and retinal detachments.