Macular edema risk factors after vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

Abstract

BACKGROUND: Despite significant advances in the technology of surgical treatment of regmatogenous retinal detachment, a certain proportion of patients with emerging macular edema against the background of silicone oil tamponade remains. AIM: To evaluate the risk factors of macular edema development and to work out a mathematical model for its prediction based on a retrospective analysis of clinical data of patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. MATERIALS AND METHODS: A retrospective case series of 64 patients (64 eyes) with regmatogenous retinal detachment complicated by grade CP proliferative vitreoretinopathy who underwent primary retinal detachment repair. Patients were divided into two groups: with the presence of macular edema in the postoperative period and without it (32 patients in each group). In all cases, at the initial examination, retinal detachment involved the macular area. RESULTS: Using regression analysis, two significant factors were identified: the sum of the 8 meridians of the visual field before surgery (p = 0.015) and the number of detached quadrants (p = 0.021). Based on the identified factors, a model for predicting macular edema occurrence in the postoperative period in the surgical treatment of regmatogenous retinal detachment was obtained. CONCLUSIONS: The investigation results allowed establishing that the retinal detachment area and the sum of the 8 meridians of the visual field are significant pre-operative factors for macular edema development in retinal detachments with proliferative vitreoretinopathy of CP 1-2 degree. The developed mathematical model based on these indicators is characterized by significant information content and allows predicting macular edema occurrence in the postoperative period. The use of the proposed prognostic model determines a differentiated approach to surgical prevention of macular edema and allows making a decision on the removal of internal limiting membrane at the preoperative stage.