Delayed Retinal Tears After Acute PVD

Journal Highlights

Ophthalmology Retina, April 2023

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Jindachomthong et al. assessed the long-term incidence of and risk factors for delayed retinal tears in cases of acute, symptomatic posterior vitreous detachment (PVD) that initially occurred without retinal tears. They found that patients with lattice degeneration were at increased risk of developing a delayed tear—and that some tears occurred as long as 6.24 years following the initial PVD diagnosis.

For this retrospective observational case series, the researchers included all patients diagnosed with an acute, symptomatic PVD without concurrent retinal breaks seen at an academic tertiary medical center between Jan. 1, 2013, and Dec. 31, 2018. The main outcome measure was time to the development of a delayed retinal tear.

The final study analysis included 389 patients (389 eyes). Patients’ mean age was 64.58 years (± 9.36 years). Mean follow-up was 1.83 years (± 1.48 years). Results of Kaplan-Meier analysis showed that 7.39% of eyes developed delayed retinal tears by 6.24 years after initial PVD diagnosis. Of these, 50% occurred within 4.63 months after the PVD, and 63.46% occurred by the one-year mark. Moreover, 55% of the delayed tears occurred after the routine six-week follow-up period for PVDs.

With regard to risk factors, results of multivariate analysis showed that the presence of lattice degeneration was significantly associated with delayed retinal tear. Younger age (<60 years) and myopia were not.

In their discussion, the authors noted that the results emphasize the need for continued and repeated long-term reevaluation after an acute, symptomatic PVD is diagnosed. In addition, they wrote, “patients should know that they may experience delayed retinal tears even after the common six-week follow-up period and be wary of new symptoms.”

The original article can be found here.