TY - JOUR
T1 - Risk of Rhegmatogenous Retinal Detachment in Acute Retinal Necrosis With and Without Prophylactic Intervention
AU - Risseeuw, Sara
AU - de Boer, Joke H.
AU - ten Dam – van Loon, Ninette H.
AU - van Leeuwen, Redmer
N1 - Funding Information:
Funding/Support: No funding or grant support. Financial Disclosures: The following authors have no financial disclosures: Sara Risseeuw, Joke H. de Boer, Ninette H. ten Dam–van Loon, and Redmer van Leeuwen. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2019 Elsevier Inc.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Purpose: To study whether preventive laser or preventive vitrectomy is able to lower the risk of rhegmatogenous retinal detachment (RRD) in patients with acute retinal necrosis (ARN). Design: A retrospective, interventional case series. Methods: We performed a retrospective study of 59 patients (63 eyes) with ARN treated in a single tertiary referral center. We analyzed different groups with either no prophylaxis, prophylactic laser, or prophylactic vitrectomy. Main outcome measure was incidence of RRD. Results: Overall incidence of RRD was 44.4%, including 13% at presentation. In a crude analysis, the risk of RRD was highest in 33 patients with prophylactic laser (45.5%), lower in 15 patients with no prophylaxis (26.7%), and lowest in 7 patients with prophylactic vitrectomy (14.3%). Baseline best-corrected visual acuity differed between these groups, but zone and percentage of involved retina did not. In a multivariable model including prophylactic laser and ARN severity, only zone was predictive of RRD. Conclusion: When correcting for severity of disease, we did not observe a reduction in the risk of RRD by prophylactic laser in eyes with ARN. Therefore, prophylactic laser may be abandoned. The role of prophylactic vitrectomy is still unclear, but deserves further investigation.
AB - Purpose: To study whether preventive laser or preventive vitrectomy is able to lower the risk of rhegmatogenous retinal detachment (RRD) in patients with acute retinal necrosis (ARN). Design: A retrospective, interventional case series. Methods: We performed a retrospective study of 59 patients (63 eyes) with ARN treated in a single tertiary referral center. We analyzed different groups with either no prophylaxis, prophylactic laser, or prophylactic vitrectomy. Main outcome measure was incidence of RRD. Results: Overall incidence of RRD was 44.4%, including 13% at presentation. In a crude analysis, the risk of RRD was highest in 33 patients with prophylactic laser (45.5%), lower in 15 patients with no prophylaxis (26.7%), and lowest in 7 patients with prophylactic vitrectomy (14.3%). Baseline best-corrected visual acuity differed between these groups, but zone and percentage of involved retina did not. In a multivariable model including prophylactic laser and ARN severity, only zone was predictive of RRD. Conclusion: When correcting for severity of disease, we did not observe a reduction in the risk of RRD by prophylactic laser in eyes with ARN. Therefore, prophylactic laser may be abandoned. The role of prophylactic vitrectomy is still unclear, but deserves further investigation.
UR - http://www.scopus.com/inward/record.url?scp=85068835823&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2019.05.023
DO - 10.1016/j.ajo.2019.05.023
M3 - Article
C2 - 31170391
AN - SCOPUS:85068835823
SN - 0002-9394
VL - 206
SP - 140
EP - 148
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -