Session Title: Vitreoretinal Surgery IV
Session Date/Time: Sunday 20/09/2015 | 09:00-10:30
Paper Time: 09:24
First Author: : M.Uyar TURKEY
Co Author(s): : R. Yildirim D. Er M. Uyar E. Karahan
PURPOSE:To evaluate predictive factors of retinal tears in the patients with the symptoms of acute posterior vitreous detachment (PVD)
All patients presenting to the Sıfa University, between September 2008 and July 2009 diagnosed with acute PVD were offered enrollment.
All patients underwent a full ophthalmologic examination including slit-lamp biomicroscopy and indirect ophthalmoscopy. Goldmann 3-mirror examination was performed in all patients. Patients with any history of ocular surgery except uncomplicated phacoemulsification cataract extraction with in the bag IOL insertion without posterior capsular rupture or vitreous loss, patients who had symptoms for longer than 1 month, and who had an identified history of blunt trauma were excluded. Only the results of one eye was used for statistical analysis. If the patient had symptoms in both eyes, the eye with severe symptoms was included to the study. Evaluated predictive factors were age, gender, spherical equivalent, intraocular pressure, lens status, presence of glaucoma, axial length, presence of peripheric retinal degeneration, type of the symptom (floater, flashing lights or both), duration of the symptoms, presence of any epiretinal membrane, presence of preretinal or intravitreal hemorrhage, presence of the history of Nd:Yag capsulotomy, time from the cataract surgery to the initial examination and if have been performed time from the Nd:Yag capsulotomy to the inital examination.
Three-hundred seventy six eyes of the 376 patients were enrolled to the study. Mean age was 54.9±13.5 years (range; 24 to 89 years). One-hundred thirty four (35.6%) patients were male and 242 patients (%64.4) were female. Fifty four (14.4%) of 376 eyes had retinal tear at initial examination. None of the evaluated factors was found to be predictive to the retinal tear in linear and multipl regression analysis. However, we found that retinal tear was found in 19 of 152 eyes (12.5%) with patients floater, whereas 7 of 28 eyes (25.0%) with flashing lights had retinal tear at initial examination (p=0.084). In 196 patients who had both floater and flashing lights 28 patients (14.3%) had retinal tear. New retinal tears detected in 4 eyes at second examination, in four eyes at third examination and no new retinal tear was found at fourth examination. All retinal tears were successfully treated with laser photocoagulation None of the patients needed vitreoretinal surgery.
In the light of our findings, we believe that at least 2 or 3 compherensive retinal examination should be performed in a patient with the symptoms of acute PVD. No predictive factor for retinal tear was determined in our study but we interestingly found that patients with only the symptom of flashing lights had a higher rate of retinal tear compared with the patients had only floater and patients who had both floater or flashing lights.