Outcomes following repair of early-onset versus delayed-onset rhegmatogenous retinal detachments after acute posterior vitreous detachment

Abstract

AimTo report anatomical and functional outcomes after surgical repair of acute-onset vs delayed-onset rhegmatogenous retinal detachments (RDs) following acute posterior vitreous detachment (PVD).MethodsA 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.ResultsA 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).ConclusionsDelayed-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.