Rhegmatogenous retinal detachment presentation and surgery in uveitic eyes

• Published in: British journal of ophthalmology Vol. 107; no. 1; pp. 116 - 120
• Main Authors: Young-Zvandasara, Tafadzwa, Brunner, David, Welch, Sarah, Sims, Joanne L, De Souza, Clairton, Cunningham, William J, Niederer, Rachael L
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.01.2023; BMJ Publishing Group LTD
• Subjects: Cataracts; choroid; ciliary body; Clinical science; Cytomegalovirus; Etiology; Humans; iris; Male; Multivariate analysis; Ophthalmology; retina; Retinal detachment; Retinal Detachment - diagnosis; Retinal Detachment - etiology; Retinal Detachment - surgery; Retrospective Studies; Risk factors; Surgery; Uveitis - complications; Uveitis - diagnosis; Uveitis - epidemiology; Visual Acuity; Vitrectomy - adverse effects; Vitreoretinopathy, Proliferative - surgery; choroid; iris; ciliary body; retina
• ISSN: 0007-1161; 1468-2079; 1468-2079
• DOI: 10.1136/bjophthalmol-2021-319268

Background/aimsTo explore the occurrence, uveitis activity, features, rate of proliferative vitreoretinopathy (PVR) and outcomes following rhegmatogenous retinal detachment (RRD) in a large tertiary referral uveitis service.MethodsRetrospective analysis of subjects attending between 2008 and 2019. Multivariate analysis of risk factors for RRD was calculated. Nelson-Aalen plots were used to demonstrate cumulative risk of RRD. Outcomes of RRD surgery and prognostic indicators were analysed.ResultsTwo thousand four hundred and forty-seven (2447) subjects (3516 eyes) with uveitis included. The mean follow-up was 5.7 years (19 767 eye-years); 56 eyes developed a RRD (1.6%). Thirty-two eyes had surgery in our unit. Risk factors for RRD were posterior uveitis or panuveitis (HR 3.386, p<0.001), male gender (HR 2.045, p=0.029) and infectious aetiology (HR 1.942, p=0.044). PVR was present in six (18.8%) eyes at presentation, and a further four (12.5%) developed it after the primary surgery. Final follow-up data showed 16 (50%) moderate or severe visual loss, although 29 (90.6%) had anatomical reattachment without oil in situ.ConclusionsThere is a high rate of RRD in uveitis eyes. This is accompanied by high rates of PVR and redetachment. Anatomical success was high, but visual outcomes remain unpredictable.