Background/aims To compare risk factors for poor visual outcomes in patients undergoing primary rhegmatogenous retinal detachment (RRD) repair and to develop a scoring system.
Methods Analysis of the Primary Retinal detachment Outcomes (PRO) study, a multicentre interventional cohort of consecutive primary RRD surgeries performed in 2015. The main outcome measure was a poor visual outcome (Snellen VA ≤20/200).
Results A total of 1178 cases were included. The mean preoperative and postoperative logMARs were 1.1±1.1 (20/250) and 0.5±0.7 (20/63), respectively. Multivariable logistic regression identified preoperative risk factors predictive of poor visual outcomes (≤20/200), including proliferative vitreoretinopathy (PVR) (OR 1.26; 95% CI 1.13 to 1.40), history of antivascular endothelial growth factor (VEGF) injections (1.38; 1.11 to 1.71), >1-week vision loss (1.17; 1.08 to 1.27), ocular comorbidities (1.18; 1.00 to 1.38), poor presenting VA (1.06 per initial logMAR unit; 1.02 to 1.10) and age >70 (1.13; 1.04 to 1.23). The data were split into training (75%) and validation (25%) and a scoring system was developed and validated. The risk for poor visual outcomes was 8% with a total score of 0, 17% with 1, 29% with 2, 47% with 3, and 71% with 4 or higher.
Conclusions Independent risk factors were compared for poor visual outcomes after RRD surgery, which included PVR, anti-VEGF injections, vision loss >1 week, ocular comorbidities, presenting VA and older age. The PRO score was developed to provide a scoring system that may be useful in clinical practice.
- treatment surgery
Data availability statement
No data are available.
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Presented at Macula Society 2021 (Virtual).
Contributors LC, JL, MS and YY were primarily responsible for data analysis as well as drafting the original manuscript. AO, EHR, CR, NJF, AC, GGE, DPJ, DE, OG, CR, JH, DA, MJA, LP and YY were primarily responsible for planning, conception and original design of the study. All authors revised the manuscript for important intellectual content and gave final approval for the version published. YY is the author responsible for the overall content as the guarantor.
Funding This study was funded by Phillips Eye Institute Foundation, Vitreo and Retinal Surgery Foundation.
Competing interests Consultant for Alcon (CR, DE, OG, YY), Grant support from Alcon (AC), Royalties from Alcon (EHR), Stockholder in Aldeyra Therapeutics (DE, CR), Consultant for Dutch Ophthalmic (DE), Scientific Advisory Board for Pykus Therapeutics (DE), Stockholder in Valiant and Glaukos (GGE).
Provenance and peer review Not commissioned; externally peer reviewed.
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