TY - JOUR
T1 - Symptom-Based Risk Factors for Retinal Tears and Detachments in Suspected Posterior Vitreous Detachment
AU - Ahmad, Meleha T.
AU - Sein, Julia
AU - Wang, Jiangxia
AU - Scott, Adrienne W.
AU - Ramroop, Janelle
AU - Jiramongkolchai, Kim
AU - Zimmer-Galler, Ingrid E.
AU - Handa, James T.
AU - Arevalo, J. Fernando
N1 - Funding Information:
Wilmer Biostatistics Core Grant EY01765; unrestricted grant from Research to Prevent Blindness (Wilmer), Robert Bond Welch Professorship (Jame Tahara Handa), and Edmund and Virginia Ball Professorship (J. Fernando Arevalo); and Wilmer Resident Retina Innovation and Research Grant Award 2018. The funding organization had no role in the design or conduct of this research.
Publisher Copyright:
© 2022 S. Karger AG, Basel.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Introduction: The aim of this study was to determine symptom-level risk factors for retinal tear/retinal detachment (RT/RD) in our patients presenting with symptoms of posterior vitreous detachment (PVD). Methods: We conducted a prospective cohort study of patients presenting to outpatient ophthalmology clinics at a single academic institution with complaint(s) of flashes, floaters, and/or subjective field loss (SFL). Patients received a standardized questionnaire regarding past ocular history and symptom characteristics including number, duration, and timing of flashes and floaters, prior to dilated ocular examination. Final diagnosis was categorized as RT/RD, PVD, ocular migraine, vitreous syneresis, or "other."Simple and multivariate logistic regressions were used to identify symptoms predictive of various pathologies. Results: We recruited 237 patients (age 20-93 years) from March 2018 to March 2019. The most common diagnosis was PVD (141, 59.5%), followed by vitreous syneresis (38, 16.0%) and RT/RD (34, 14.3%). Of those with RT/RD, 16 (47.1%) had retinal tear and 15 (44.1%) had RD. Significant differences in demographic and examination-based factors were observed between these groups. Symptom-based predictive factors for RT/RD were the presence of subjective visual reduction (SVR; OR 2.77, p = 0.03) or SFL (OR 2.47, p = 0.04), and the absence of either floaters (OR 4.26, p = 0.04) or flashes (OR 2.95, p = 0.009). The number, duration, and timing of flashes and floaters did not predict the presence of RT/RD in our cohort. Within the RT/RD group, patients with RT were more likely to report floaters (100% vs. 66.7%, p = 0.018) and less likely to report SFL (0% vs. 86.7%, p < 0.001) compared to those with RD. Conclusion: While well-known demographic and exam-based risk factors for RT/RD exist in patients with PVD symptoms, the relative importance of symptom characteristics is less clear. We found that the presence of SVR and SFL, as well as the absence of either flashes or floaters, predicts RT/RD in patients with PVD symptoms. However, the number, duration, and timing of flashes and floaters may be less relevant in the triage of these patients.
AB - Introduction: The aim of this study was to determine symptom-level risk factors for retinal tear/retinal detachment (RT/RD) in our patients presenting with symptoms of posterior vitreous detachment (PVD). Methods: We conducted a prospective cohort study of patients presenting to outpatient ophthalmology clinics at a single academic institution with complaint(s) of flashes, floaters, and/or subjective field loss (SFL). Patients received a standardized questionnaire regarding past ocular history and symptom characteristics including number, duration, and timing of flashes and floaters, prior to dilated ocular examination. Final diagnosis was categorized as RT/RD, PVD, ocular migraine, vitreous syneresis, or "other."Simple and multivariate logistic regressions were used to identify symptoms predictive of various pathologies. Results: We recruited 237 patients (age 20-93 years) from March 2018 to March 2019. The most common diagnosis was PVD (141, 59.5%), followed by vitreous syneresis (38, 16.0%) and RT/RD (34, 14.3%). Of those with RT/RD, 16 (47.1%) had retinal tear and 15 (44.1%) had RD. Significant differences in demographic and examination-based factors were observed between these groups. Symptom-based predictive factors for RT/RD were the presence of subjective visual reduction (SVR; OR 2.77, p = 0.03) or SFL (OR 2.47, p = 0.04), and the absence of either floaters (OR 4.26, p = 0.04) or flashes (OR 2.95, p = 0.009). The number, duration, and timing of flashes and floaters did not predict the presence of RT/RD in our cohort. Within the RT/RD group, patients with RT were more likely to report floaters (100% vs. 66.7%, p = 0.018) and less likely to report SFL (0% vs. 86.7%, p < 0.001) compared to those with RD. Conclusion: While well-known demographic and exam-based risk factors for RT/RD exist in patients with PVD symptoms, the relative importance of symptom characteristics is less clear. We found that the presence of SVR and SFL, as well as the absence of either flashes or floaters, predicts RT/RD in patients with PVD symptoms. However, the number, duration, and timing of flashes and floaters may be less relevant in the triage of these patients.
KW - Flashes
KW - Floaters
KW - Posterior vitreous detachment
KW - Retinal detachment
KW - Retinal tear
KW - Symptoms
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U2 - 10.1159/000527295
DO - 10.1159/000527295
M3 - Article
C2 - 36228586
AN - SCOPUS:85147047257
SN - 0030-3755
VL - 245
SP - 570
EP - 576
JO - Ophthalmologica
JF - Ophthalmologica
IS - 6
ER -