Outcomes of surgical repair of Retinoschisis-associated retinal detachment compared to Rhegmatogenous retinal detachment

BMC Ophthalmology

Jérôme Garneau¹  Éric Tourville²  Mathieu Caissie²  Mélanie Hébert²  Ali Dirani²  Eunice You²  Serge Bourgault²  Alexandre Lachance² 

[1] Faculty of Medicine, Université Laval, Quebec, Canada;Faculty of Medicine, Université Laval, Quebec, Canada;Department of Ophthalmology, Centre Universitaire d’Ophtalmologie, CHU de Québec - Université Laval (Hôpital du Saint-Sacrement), 1050 chemin Ste Foy, G1S4L8, Québec, Canada;

关键词: Outer later breaks;    Pars plana vitrectomy;    Retinal detachment;    Retinal detachment repair;    Retinoschisis;    Scleral buckle;   

DOI  :  10.1186/s12886-021-02232-7

来源: Springer

【 摘 要 】

BackgroundThe aim of this study is to compare outcomes of primary retinal detachment (RD) repair in retinoschisis-associated RD (RSRD) and rhegmatogenous RD (RRD).MethodsThis is a retrospective observational cohort study. Charts of 2247 consecutive patients operated for RD repair at the Centre hospitalier universitaire de Québec – Université Laval between 2014 and 2018 were reviewed. Patients with RSRD and RRD were included to compare the visual and anatomical outcomes of both groups.ResultsThere were 41 patients (1.8%) with RSRD and 1661 patients (74%) with RRD. RSRD patients had more primary repair failures (n = 9, 22%, vs. n = 166, 10%; p = 0.013). The primary anatomical success rates for pars plana vitrectomy with and without scleral buckle (PPV-SB vs. PPV) as primary repair method were similar in both RSRD patients (n = 11/14, 79% vs. n = 20/25, 80%; p = 0.92) and RRD patients (n = 751/827, 91% vs. n = 641/721, 89%; p = 0.21). At final follow-up, best corrected visual acuity (VA) in logarithm of the minimum angle of resolution (logMAR) was 0.30 [0.10, 0.88] and 0.18 [0.10, 0.40] (p = 0.03) in RSRD patients and RRD patients, respectively. Presence of retinoschisis was associated with worse final VA (β 0.082, p < 0.001). Other predictive variables included female sex, macula-off presentation, number of RD quadrants involved, longer symptoms duration, worse baseline VA, and primary repair failure. The greatest predictors were worse baseline VA, primary repair failure, and macula-off status at presentation. Presence of retinoschisis did not significantly increase risk of primary repair failure in multivariable analysis (OR 1.45, 95% CI: 0.50–4.17; p = 0.49). Symptoms duration was the greatest effect factor associated with for primary repair failure (OR 1.37, 95% CI: 1.12–1.69; p = 0.003).ConclusionsRSRD is associated with more primary repair failure in univariate analysis, but not in multivariate analysis after adjusting for symptoms duration. It is however associated with worse final VA even after adjusting for primary repair failure. Both PPV and PPV-SB are valid repair methods for RSRD. However, RSRD remains a challenge to treat.

【 授权许可】

CC BY