Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
The Retina Service, Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania, USA.
Br J Ophthalmol. 2024 Mar 20;108(4):552-557. doi: 10.1136/bjo-2022-322530.
To report anatomical and functional outcomes after surgical repair of acute-onset vs delayed-onset rhegmatogenous retinal detachments (RDs) following acute posterior vitreous detachment (PVD).
A 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.
A 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).
Delayed-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.
报告急性后玻璃体脱离（PVD）后急性发作和延迟发作孔源性视网膜脱离（RD）的手术修复后的解剖和功能结果。
回顾性、对照性干预队列研究，其中 2015 年 10 月至 2020 年 3 月间在一家单一中心视网膜诊所就诊的患者中，延迟性 RD（在急性 PVD 初次发作后≥42 天诊断）与 2：1 年龄匹配和性别匹配的急性 RD 队列（初次发作时 PVD 和 RD）进行比较。主要结局是 RD 修复后 3 个月的最终附着率和单次手术解剖成功率（SSAS）。
共分析了 210 只眼-70 只在延迟性 RD 组，140 只在急性 RD 组。延迟性 RD 组的 SSAS 为 58/70（82.9%），急性 RD 组为 112/140（80%）（p=0.71）。在 RD 诊断时，延迟性 RD 组的最小分辨角视力对数（VA）平均值（标准差）为 0.51（0.70）（Snellen，20/65），而急性 RD 组为 1.04（0.92）（Snellen，20/219）（p<0.001）。延迟性 RD 组在修复后 1 个月和 3 个月时的 VA 更好（p=0.005 和 0.041），但在修复后 6 个月、12 个月和最终随访时相似（p=0.48、0.27 和 0.23）。
初次就诊于视网膜专家时出现急性 PVD 后≥6 周的延迟性 RD，在 RD 诊断时 VA 通常较好，与初次发作时诊断的急性 RD 相比，术后视力恢复较快。两组在解剖学结果上无显著差异。
