Aim To report anatomical and functional outcomes after surgical repair of acute-onset vs delayed-onset rhegmatogenous retinal detachments (RDs) following acute posterior vitreous detachment (PVD).
Methods A retrospective, comparative interventional cohort study where patients presenting to a single-centre retina practice between October 2015 and March 2020 with delayed RDs (diagnosed ≥42 days after initial presentation of acute PVD) were compared with a 2:1 age-matched and gender-matched acute RD cohort (PVD and RD at initial presentation). The primary outcome was the final attachment rate and single surgery anatomic success (SSAS) at 3 months after RD repair.
Results A total of 210 eyes were analysed—70 in the delayed RD group and 140 in the acute RD group. SSAS was 58/70 (82.9%) for the delayed RD group and 112/140 (80%) for the acute RD group (p=0.71). At the time of RD diagnosis, mean (SD) logarithm of minimum angle of resolution visual acuity (VA) was 0.51 (0.70) (Snellen, 20/65) in the delayed RD group vs 1.04 (0.92) (Snellen, 20/219) in the acute RD group (p<0.001). Mean VA was better at 1 and 3 months post-repair in the delayed RD group (p=0.005 and 0.041, respectively) but similar by 6 months, 12 months and at the final visit post-repair (p=0.48, 0.27, and 0.23, respectively).
Conclusions Delayed-onset RDs occurring ≥6 weeks after initial presentation to a retina specialist with an acute PVD generally had better VA at the time of RD diagnosis and faster post-surgical visual recovery compared with acute-onset RDs diagnosed at the initial presentation. No significant difference in anatomic outcomes was seen between the two groups.
Data availability statement
Data are available upon reasonable request.
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VBS and MS are joint first authors.
Twitter @VSwaminathanMD, @JasonHsuMD
VBS and MS contributed equally.
Contributors VBS, MS, RI, EC, RM and JHU contributed equally to data collection, data analysis and manuscript writing. JHU, MJS, MK, SG and JH contributed to data analysis, served as scientific advisors and provided and cared for study patients. JH, VBS and MS contributed to project conception. JH is the guarantor. VBS and MS contributed equally as co-first authors.
Funding J. Arch McNamara, MD Fund for Retina Research and Education (Wills Eye Hospital); Grant Number: None.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.