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Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses

PURPOSE: To investigate risk factors, imaging characteristics, and treatment responses of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. METHODS: Consecutive, retrospective case–control series of patients who underwent pars plana vitrectomy (PPV) and/or scleral buc...

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Autores principales: Pole, Cameron, Chehaibou, Ismael, Govetto, Andrea, Garrity, Sean, Schwartz, Steven D., Hubschman, Jean-Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831177/
https://www.ncbi.nlm.nih.gov/pubmed/33494835
http://dx.doi.org/10.1186/s40942-020-00254-9
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author Pole, Cameron
Chehaibou, Ismael
Govetto, Andrea
Garrity, Sean
Schwartz, Steven D.
Hubschman, Jean-Pierre
author_facet Pole, Cameron
Chehaibou, Ismael
Govetto, Andrea
Garrity, Sean
Schwartz, Steven D.
Hubschman, Jean-Pierre
author_sort Pole, Cameron
collection PubMed
description PURPOSE: To investigate risk factors, imaging characteristics, and treatment responses of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. METHODS: Consecutive, retrospective case–control series of patients who underwent pars plana vitrectomy (PPV) and/or scleral buckling (SB) for RRD, with at least six months of follow-up. Clinical and surgical parameters of patients with and without CME (nCME), based on spectral-domain optical coherence tomography (OCT), were compared. RESULTS: Of 99 eyes enrolled, 25 had CME while 74 had nCME. Patients with CME underwent greater numbers of surgeries (P < 0.0001). After adjusting for number of surgeries, macula-off RRD (P = 0.06), proliferative vitreoretinopathy (PVR) (P = 0.09), surgical approach (PPV and/or SB, P = 0.21), and tamponade type (P = 0.10) were not statistically significant, although they all achieved significance on univariate analysis (P = 0.001 or less). Intraoperative retinectomy (P = 0.009) and postoperative pseudophakia or aphakia (P = 0.008) were more frequent in the CME group, even after adjustment. Characteristics of cCME on OCT included diffuse distribution, confluent cysts, and absence of subretinal fluid or intraretinal hyperreflective foci. Macular thickness improved significantly with intravitreal triamcinolone (P = 0.016), but not with anti-vascular endothelial growth factor agents (P = 0.828) or dexamethasone implant (P = 0.125). After adjusting for number of surgeries and macular detachment, final visual acuities remained significantly lower in the CME vs nCME group (P = 0.012). CONCLUSION: Risk factors of CME include complex retinal detachment repairs requiring multiple surgeries, and pseudophakic or aphakic lens status. Although this cCME was associated with poor therapeutic response, corticosteroids were the most effective studied treatments.
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spelling pubmed-78311772021-01-26 Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses Pole, Cameron Chehaibou, Ismael Govetto, Andrea Garrity, Sean Schwartz, Steven D. Hubschman, Jean-Pierre Int J Retina Vitreous Original Article PURPOSE: To investigate risk factors, imaging characteristics, and treatment responses of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. METHODS: Consecutive, retrospective case–control series of patients who underwent pars plana vitrectomy (PPV) and/or scleral buckling (SB) for RRD, with at least six months of follow-up. Clinical and surgical parameters of patients with and without CME (nCME), based on spectral-domain optical coherence tomography (OCT), were compared. RESULTS: Of 99 eyes enrolled, 25 had CME while 74 had nCME. Patients with CME underwent greater numbers of surgeries (P < 0.0001). After adjusting for number of surgeries, macula-off RRD (P = 0.06), proliferative vitreoretinopathy (PVR) (P = 0.09), surgical approach (PPV and/or SB, P = 0.21), and tamponade type (P = 0.10) were not statistically significant, although they all achieved significance on univariate analysis (P = 0.001 or less). Intraoperative retinectomy (P = 0.009) and postoperative pseudophakia or aphakia (P = 0.008) were more frequent in the CME group, even after adjustment. Characteristics of cCME on OCT included diffuse distribution, confluent cysts, and absence of subretinal fluid or intraretinal hyperreflective foci. Macular thickness improved significantly with intravitreal triamcinolone (P = 0.016), but not with anti-vascular endothelial growth factor agents (P = 0.828) or dexamethasone implant (P = 0.125). After adjusting for number of surgeries and macular detachment, final visual acuities remained significantly lower in the CME vs nCME group (P = 0.012). CONCLUSION: Risk factors of CME include complex retinal detachment repairs requiring multiple surgeries, and pseudophakic or aphakic lens status. Although this cCME was associated with poor therapeutic response, corticosteroids were the most effective studied treatments. BioMed Central 2021-01-25 /pmc/articles/PMC7831177/ /pubmed/33494835 http://dx.doi.org/10.1186/s40942-020-00254-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Article
Pole, Cameron
Chehaibou, Ismael
Govetto, Andrea
Garrity, Sean
Schwartz, Steven D.
Hubschman, Jean-Pierre
Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title_full Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title_fullStr Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title_full_unstemmed Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title_short Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses
title_sort macular edema after rhegmatogenous retinal detachment repair: risk factors, oct analysis, and treatment responses
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831177/
https://www.ncbi.nlm.nih.gov/pubmed/33494835
http://dx.doi.org/10.1186/s40942-020-00254-9
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