PRO score: predictive scoring system for visual outcomes after rhegmatogenous retinal detachment repair

Area of Science:

• Ophthalmology
• Retinal Surgery
• Visual Outcomes Research

Background:

• Rhegmatogenous retinal detachment (RRD) repair aims to restore vision.
• Predicting visual outcomes after RRD surgery is essential for patient management.
• Risk factors for poor visual outcomes require further investigation.

Purpose of the Study:

• To identify and compare risk factors associated with poor visual outcomes following primary RRD repair.
• To develop and validate a predictive scoring system for visual outcomes in RRD patients.

Main Methods:

• Analysis of the multicentre interventional Primary Retinal detachment Outcomes (PRO) study cohort.
• Inclusion of 1178 consecutive primary RRD surgeries performed in 2015.
• Utilizing multivariable logistic regression to identify preoperative risk factors for poor visual outcomes (Snellen VA ≤20/200).

Main Results:

• Proliferative vitreoretinopathy (PVR), anti-VEGF injections, vision loss >1 week, ocular comorbidities, poor presenting visual acuity (VA), and older age (>70) were significant risk factors.
• A scoring system (PRO score) was developed and validated, demonstrating increasing risk of poor visual outcomes with higher scores.
• The PRO score ranged from 8% risk with a score of 0 to 71% risk with a score of 4 or higher.

Conclusions:

• Key independent risk factors for poor visual outcomes in RRD surgery include PVR, anti-VEGF history, prolonged vision loss, comorbidities, presenting VA, and advanced age.
• The developed PRO score offers a practical tool for assessing and managing patients undergoing RRD repair.
• The PRO score can aid clinicians in predicting visual prognosis and guiding treatment strategies.