Timing of Delayed Retinal Pathology in Patients Presenting with Acute Posterior Vitreous Detachment in the IRIS® Registry (Intelligent Research in Sight)

Gautam Vangipuram; Charles Li; Siying Li; Lynn Liu; Linda D Harrison; Flora Lum; Gaurav K Shah

doi:10.1016/j.oret.2023.04.004

Timing of Delayed Retinal Pathology in Patients Presenting with Acute Posterior Vitreous Detachment in the IRIS® Registry (Intelligent Research in Sight)

Ophthalmol Retina. 2023 Aug;7(8):713-720. doi: 10.1016/j.oret.2023.04.004. Epub 2023 Apr 18.

Authors

Gautam Vangipuram¹, Charles Li², Siying Li², Lynn Liu², Linda D Harrison³, Flora Lum², Gaurav K Shah⁴

Affiliations

¹ Beach Cities Retina, Hermosa Beach, California.
² American Academy of Ophthalmology, San Francisco, California.
³ Ophthalmic Mutual Insurance Company, San Francisco, California.
⁴ West Coast Retina, San Francisco, California. Electronic address: gkshah1@gmail.com.

PMID: 37080486
DOI: 10.1016/j.oret.2023.04.004

Abstract

Objective: To determine the timing of delayed retinal pathology in eyes presenting with acute posterior vitreous detachment (PVD).

Design: Retrospective database study.

Subjects: Patients in the Intelligent Research in Sight (IRIS) registry found to have acute PVD based on the International Classification of Diseases, Ninth and Tenth Revision, codes were followed.

Methods: Patients coded to have a PVD from 2013 to 2018 along with common procedural technology coding of extended ophthalmoscopy were included. Ocular baseline characteristics included visual acuity, lens status, presence or absence of vitreous hemorrhage, myopia, lattice degeneration, and subspecialty training of the treating physician.

Main outcome measures: Timing (days) to delayed retinal break or detachment RESULTS: A total of 434 046 eyes met inclusion/exclusion criteria, and 10 518 eyes (2.42%) presented with a delayed retinal break or detachment after initial PVD. The median time to retinal break and detachment after initial PVD was 42 (range, 1-365) days and 51 (range, 1-365) days, respectively. Eyes with vitreous hemorrhage (hazard ratio [HR], 9.30; 95% confidence interval [CI], 8.50-10.2), history of retinal break/retinal detachment in the fellow eye (HR, 3.91; 95% CI, 3.64-4.20), lattice degeneration (HR, 2.61; 95% CI, 2.35-2.90), and myopia (HR, 1.42; 95% CI, 1.33-1.53) were found to be at a higher risk of developing delayed break or detachment.

Conclusions: Follow-up examination after initial PVD is necessary to diagnose delayed or missed retinal pathology. In eyes with no initial pathology, providers should consider repeat examination at least once within 6 weeks, and sooner for eyes with higher-risk features.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.

Keywords: IRIS registry; Posterior vitreous detachment; Retinal detachment; Retinal tear; Vitreous.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Myopia*
Retinal Degeneration*
Retinal Detachment* / diagnosis
Retinal Perforations* / diagnosis
Retrospective Studies
Vitreous Detachment* / diagnosis
Vitreous Hemorrhage / diagnosis
Vitreous Hemorrhage / etiology