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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-05-2019 | Retinal Detachment | Retinal Disorders

Fovea-sparing rhegmatogenous retinal detachments: impact of clinical factors including time to surgery on visual and anatomic outcomes

Authors: Irene T. Lee, Shaun I.R. Lampen, Tien P. Wong, James C. Major Jr, Charles C. Wykoff

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 5/2019

Abstract

Purpose

Evaluate the impact of time to surgery and other clinical factors on visual and anatomic outcomes following surgical repair of fovea-sparing rhegmatogenous retinal detachments (RRD).

Methods

Visual and anatomic outcomes were analyzed for their association with clinical factors, including lens status, preoperative visual acuity (VA), contralateral RRD, RRD symptom duration, time to surgery, single-operation anatomic success, number of quadrants involved, posterior RRD extent, RRD extent closest to the fovea, number of retinal breaks, quadrants with retinal breaks, and surgery performed Saturday or Sunday versus Monday–Friday.

Results

Medical records of 423 eyes with fovea-sparing RRD repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), and PPV with SB (PPV/SB) were included. Sixty-seven percent and 89% were operated within 24 and 72 h of RRD presentation, respectively. Single-operation anatomic success rates were 59%, 89%, 84%, and 92% for PR, SB, PPV, and PPV/SB interventions, respectively. Final anatomic success was 100%. Three clinical factors correlated with faster time to surgery: shorter symptom duration (p < 0.02), RRD superior location (p = 0.001), and posterior extension into the macula (p = 0.01). The time to surgery did not correlate with visual or anatomic outcomes. Two clinical factors positively correlated with postoperative vision: preoperative VA (r > 0.25, p < 0.04) and single-operation anatomic success (p < 0.04). Surgeries performed on Monday through Friday (n = 411) were associated with better anatomic outcomes compared with the limited number performed on Saturday or Sunday (n = 12) (p = 0.005), although a greater proportion of operated cases over the weekend were PR.

Conclusions

In the context of the current series, time to surgery did not correlate with visual or anatomic outcomes following the surgical repair of fovea-sparing RRDs. Preoperative VA and single-operation anatomic success correlated with improved visual outcome.

Burton TC, Lambert RW (1978) A predictive model for visual recovery following retinal detachment surgery. Ophthalmology 85:619–625CrossRefPubMed

Tani P, Robertson DM, Langworthy A (1980) Rhegmatogenous retinal detachment without macular involvement treated with scleral buckling. Am J Ophthalmol 90:503–508CrossRefPubMed

Wilkinson CP (1981) Visual results following scleral buckling for retinal detachments sparing the macula. Retina 1:113–116CrossRefPubMed

Salicone A, Smiddy WE, Venkatraman A, Feuer W (2006) Visual recovery after scleral buckling procedure for retinal detachment. Ophthalmology 113:1734–1742CrossRefPubMed

Geller SF, Lewis GP, Fisher SK (2001) FGFR1, signaling, and AP-1 expression after retinal detachment: reactive Müller and RPE cells. Invest Ophthalmol Vis Sci 42:1363–1369PubMed

Nakazawa T, Matsubara A, Noda K, Hisatomi T, She H, Skondra D et al (2006) Characterization of cytokine responses to retinal detachment in rats. Mol Vis 12:867–878PubMed

Iandiev I, Uckermann O, Pannicke T, Wurm A, Tenckhoff S, Pietsch U-C et al (2006) Glial cell reactivity in a porcine model of retinal detachment. Invest Ophthalmol Vis Sci 47:2161–2171CrossRefPubMed

Hollborn M, Francke M, Iandiev I, Bühner E, Foja C, Kohen L et al (2008) Early activation of inflammation- and immune response-related genes after experimental detachment of the porcine retina. Invest Ophthalmol Vis Sci 49:1262–1273CrossRefPubMed

Wykoff CC, Smiddy WE, Mathen T, Schwartz SG, Flynn HW, Shi W (2010) Fovea-sparing retinal detachments: time to surgery and visual outcomes. Am J Ophthalmol 150:205–210CrossRefPubMed

10.

Ho SF, Fitt A, Frimpong-Ansah K, Benson MT (2006) The management of primary rhegmatogenous retinal detachment not involving the fovea. Eye 20:1049–1053CrossRefPubMed

11.

Ehrlich R, Niederer RL, Ahmad N, Polkinghorne P (2013) Timing of acute macula-on rhegmatogenous retinal detachment repair. Retina 33:105–110CrossRefPubMed

12.

Lai MM, Khan N, Weichel ED, Berinstein DM (2011) Anatomic and visual outcomes in early versus late macula-on primary retinal detachment repair. Retina 31:93–98CrossRefPubMed

13.

Wilkinson CP, Rice TA (1997) Michels Retinal Detachment St. Louis, Missouri

14.

Kontos A, Williamson TH (2017) Rate and risk factors for the conversion of fovea-on to fovea-off rhegmatogenous retinal detachment while awaiting surgery. Br J Ophthalmol 101:1011–1015CrossRefPubMed

15.

No a l (1990) The repair of rhegmatogenous retinal detachments. Ophthalmology 97:1562–1572CrossRef

16.

Hartz AJ, Burton TC, Gottlieb MS, McCarty DJ, Williams DF, Prescott A et al (1992) Outcome and cost analysis of scheduled versus emergency scleral buckling surgery. Ophthalmology 99:1358–1363CrossRefPubMed

17.

Frimpong-Ansah K, Kirkby GR (2000) Arrangements for the management of urgent retinal detachments in the United Kingdom and Eire in the year 2000: results of a survey. Eye 16:754–760CrossRef

18.

Rojas J, Fernández I, Pastor JC, Gómez-Ulla F, Piñero A (2007) Urgent retinal detachment management by the National Health System of Spain. Project retina 2. Arch Soc Esp Oftalmol 82:279–284CrossRefPubMed

19.

Goldstein SD, Papandria DJ, Aboagye J, Salazar JH, Van Arendonk K, Al-Omar K et al (2014) The “weekend effect” in pediatric surgery - increased mortality for children undergoing urgent surgery during the weekend. J Pediatr Surg 49:1087–1091CrossRefPubMed

20.

Zapf MAC, Kothari AN, Markossian T, Gupta GN, Blackwell RH, Wai PY et al (2015) The “weekend effect” in urgent general operative procedures. Surgery 158:508–514CrossRefPubMedPubMedCentral

21.

Desai V, Gonda D, Ryan SL, Briceño V, Lam SK, Luerssen TG et al (2015) The effect of weekend and after-hours surgery on morbidity and mortality rates in pediatric neurosurgery patients. J Neurosurg Pediatr 16:726–731CrossRefPubMed

22.

Tadisina KK, Chopra K, Singh DP (2015) The “weekend effect” in plastic surgery: analyzing weekday versus weekend admissions in body contouring procedures from 2000 to 2010. Aesthet Surg J 35:995–998CrossRefPubMed

23.

Algvere P, Rosengren B, Immobilization of the eye (1977) Evaluation of a new method in retinal detachment surgery. Acta Ophthalmol 55:303–316CrossRef

24.

Lean JS, Mahmood M, Manna R, Chignell AH (1980) Effect of preoperative posture and binocular occlusion on retinal detachment. Br J Ophthalmol 64:94–97CrossRefPubMedPubMedCentral

25.

Johnston PB, Collins A, Maguire CJ, Logan WC (1982) Ocular immobilization and its role in the management of superior retinal detachment. Trans Ophthalmol Soc U K 102:233–236PubMed

26.

Lincoff H, Stopa M, Kreissig I (2004) Ambulatory binocular occlusion. Retina 24:246–253CrossRefPubMed

27.

Foster WJ (2011) Bilateral patching in retinal detachment: fluid mechanics and retinal “settling”. Invest Ophthalmol Vis Sci 52:5437–5440CrossRefPubMedPubMedCentral

28.

de Jong JH, Vigueras-Guillén JP, Simon TC, Timman R, Peto T, Vermeer KA et al (2017) Preoperative posturing of patients with macula-on retinal detachment reduces progression toward the fovea. Ophthalmology 124:1510–1522CrossRefPubMed

29.

Writing Committee for the UK Age-Related Macular Degeneration EMR Users Group (2014) The neovascular age-related macular degeneration database: multicenter study of 92,976 ranibizumab injections: report 1: visual acuity. Ophthalmology 121:1092–1101CrossRef

30.

Bressler SB, Qin H, Beck RW, Chalam K, Kim JE, Melia M et al (2012) Factors associated with changes in visual acuity and OCT thickness at 1 year after treatment for diabetic macular edema with ranibizumab. Arch Ophthalmol 130:1153–1161CrossRefPubMedPubMedCentral

31.

Cohen E, Zerach A, Mimouni M, Barak A (2015) Reassessment of pneumatic retinopexy for primary treatment of rhegmatogenous retinal detachment. Clin Ophthalmol 9:2033–2037PubMedPubMedCentral

32.

Sodhi A, Leung L-S, Do DV, Gower EW, Schein OD, Handa JT (2008) Recent trends in the management of rhegmatogenous retinal detachment. Surv Ophthalmol 53:50–67CrossRefPubMed

33.

Weichel ED, Martidis A, Fineman MS, McNamara JA, Park CH, Vander JF et al (2006) Pars plana vitrectomy versus combined pars plana vitrectomy-scleral buckle for primary repair of pseudophakic retinal detachment. Ophthalmology 113:2033–2040CrossRefPubMed

34.

Kinori M, Moisseiev E, Shoshany N, Fabian ID, Skaat A, Barak A et al (2011) Comparison of pars plana vitrectomy with and without scleral buckle for the repair of primary rhegmatogenous retinal detachment. Am J Ophthalmol 152:291–297CrossRefPubMed

35.

Lindsell LB, Sisk RA, Miller DM, Foster RE, Petersen MR, Riemann CD et al (2016) Comparison of outcomes: scleral buckling and pars plana vitrectomy versus vitrectomy alone for primary repair of rhegmatogenous retinal detachment. Clin Ophthalmol 11:47–54CrossRefPubMedPubMedCentral

36.

Cankurtaran V, Citirik M, Simsek M, Tekin K, Teke MY (2017) Anatomical and functional outcomes of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment. Bosn J Basic Med Sci 17:74–80PubMedPubMedCentral

37.

Azad RV, Chanana B, Sharma YR, Vohra R (2007) Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. Acta Ophthalmol Scand 85:540–545CrossRefPubMed

38.

Kreissig I (1977) Prognosis of return of macular function after retinal reattachment. Mod Probl Ophthalmol 18:415–429PubMed

39.

Davidorf FH, Havener WH, Lang JR (1975) Macular vision following retinal detachment surgery. Ophthalmic Surg 6:74–81PubMed

Title: Fovea-sparing rhegmatogenous retinal detachments: impact of clinical factors including time to surgery on visual and anatomic outcomes
Authors: Irene T. Lee
Shaun I.R. Lampen
Tien P. Wong
James C. Major Jr
Charles C. Wykoff
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keyword: Retinal Detachment
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 5/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-018-04236-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Fovea-sparing rhegmatogenous retinal detachments: impact of clinical factors including time to surgery on visual and anatomic outcomes

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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