Proliferative vitreoretinopathy--at what risk is the fellow eye?

To find out if patients with proliferative vitreoretinopathy (PVR) due to complicated retinal detachment are at risk to acquire the same disease or other vision-threatening retinal abnormalities in the fellow eye. To furthermore assess in what time-period they appear and if subgroups of patients have special risks.

100 consecutive PVR-patients were studied retrospectively. 21 patients with PVR graded lower than C3, traumatic PVR, diabetic retinopathy or congenital vitreoretinal diseases were excluded. Age, gender, best-corrected visual acuity at the first and last visit, refraction, ocular disease in both eyes and observation-time were recorded.

After a mean follow-up of 8.5 years, 42 of 79 patients (53.4%) showed vision-threatening abnormalities in their fellow eyes: among them, 9 patients (11.4%) had PVR, 13 (16%) simple retinal detachments and 14 (17.3%) retinal breaks. Abnormalities in the fellow eye did not develop after a certain time following surgery of the primary eye; 71.4% appeared within 5 years. Aphakic and pseudophakic patients had retinal breaks significantly more often (p = 0.011) than phakic patients. Myopia did not increase the risk for any abnormality. Men developed retinal detachment (p = 0.037) and PVR (p = 0.025) significantly more often than women.

Patients with PVR have a greater than 50% risk of developing vision-threatening retinal abnormalities in their fellow eye. Because of this increased risk, these patients need regularly-scheduled long-term follow-up.

Patients with PVR have a greater than 50% risk of developing vision-threatening retinal abnormalities in their fellow eye and a 37% risk to develop PVR from rhegmatogenous retinal detachment. More than two thirds of abnormalities in the fellow eye developed within five years of surgery of the primary eye.