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Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment
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  • Published on:
    Response to: Response to "Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment"
    • Verena C Mulder, PharmD The Rotterdam Eye Hospital/Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
    • Other Contributors:
      • Jan Tode, MD
      • Elon HC van Dijk, MD
      • Jan C van Meurs, MD
      • Felix Treumer, MD

    Thank you for your interest in our publication entitled "Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment".

    As per request, we would like to provide more details on our protocol.

    As described in our discussion, centre 1 used the mean of ten correct measurements making sure these measurements did not differ more than 2 standard deviations from each other. In centre 2, seven correct measurements were recorded of which the highest and lowest value were discarded leaving an average of five measurements. A correct measurement meant that the background readings did not differ more than 15% (indicated by the code ‘BG’ on the output) and that single “cell/C” measurements were replaced by an additional measurement. In addition, measurements with a small signal to noise ratio (indicated by the code ‘s/n’) were avoided as much as possible. However, with low flare values this was not always feasible. The flare meters were located in a room with blinds (centre 1) and a room without windows (centre 2); computer screens and lights were turned off during measurements. Both flare meters were calibrated monthly to assure correct readings. We therefore believe that the included mean values are artefact free.

    Despite the exclusion of patients with additional conditions such as AMD, CRVO and preoperative PVR grade C or higher, we did end up with patients with a preopera...

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    Conflict of Interest:
    None declared.
  • Published on:
    Response to "Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment"
    • Friederike Schaub, MD Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
    • Other Contributors:
      • Bernd Kirchhof, MD
      • Sascha Fauser, MD

    We noticed the article entitled "Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment" by Mulder and associates with interest.(1)

    Several studies have been published concluding that elevated aqueous flare values seem to be associated with increased risk for PVR redetachment.(2-4) Schroeder et al reported that values >15 photon counts per milliseconds (pc/ms) increases the risk for PVR 16-fold.(4) Hoerster et al showed that the odds ratio for PVR development with preoperative flare values >15pc/ms was 30.7 (p=0.0001) with a sensitivity of 80% and specificity of 79%.(3) Conart et al verified these findings (OR 12.3, p<0.0001 for later PVR in flare values >15 pc/ms).(2)

    In contrast Mulder et al concluded on their data compilation that laser flare measurements are inaccurate in predicting PVR.(1) Logistic regression analyses showed a significant increase in odds with increasing flare at least for the second centre (1) supporting the notion that high flare measurements herald PVR. However, the large variation precluded sufficient sensitivity and specificity to separate between groups. We assume the reason for the large variation is that high-level outliers were included. For center 2 only the highest and the lowest values were excluded, no information is provided for center 1. Values of 100pc/ms, here up to 312pc/ms, are uncommon for the low-level type of i...

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    Conflict of Interest:
    None declared.