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Published on: May 24, 2015
Analysis of Fellow Eye Posterior Vitreous Detachment and Complications Using a Large Database of Retina Specialists
John Brown1, Curtis Heisel1, Nick Boucher2
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Purpose:
To identify risk factors in diagnosis of second-eye posterior vitreous detachment (PVD) after first-eye PVD and subsequent complications.
Design:
Multicenter, retrospective observational study.
Participants:
22.525 patients with first-eye PVD (2015-2024) from the CorEvitas Vestrum Health Database.
Methods:
Onset of fellow eye PVD and development of fellow eye complications (vitreous hemorrhage, retinal break, and retinal detachment) were evaluated after acute unilateral PVD and throughout at 9-year study period.
Main Outcome Measures:
Time to develop fellow eye PVD following acute unilateral PVD and risk factors associated with developing complications in fellow eye after PVD.
Results:
Of 22 525 patients, 38.3% were diagnosed with complications after first-eye PVD within 1 year (24.3% vitreous hemorrhage [VH], 24.1% retinal break [RB], 5.2% retinal detachment [RD]). Second-eye PVD occurred in 21.2% of the 22,525 patients. The median time to diagnosis of second-eye PVD was 37 months, with 74.5% of patients diagnosed with a second-eye PVD having it within 72 months. Increased risk of second-eye PVD was associated with first-eye VH (hazard ratio [HR] 1.08, P = 0.027), first-eye RB (HR 1.13, P < 0.001), lattice degeneration in either eye (HR 1.09, P = 0.037), and pseudophakia in the second eye (HR 1.21, P < 0.001). Age >65 years (HR 0.79, P < 0.001) and male gender (HR 0.93, P = 0.022) reduced risk. In eyes that experienced a second-eye PVD, 33.2% had associated complications, of which 21.1% were detected within 12 months. Risk factors included male gender (HR 1.46, P < 0.001), lattice degeneration in either eye (HR 1.38, P < 0.001), and first-eye VH (HR 2.09, P < 0.001), RB (HR 1.78, P < 0.001), or RD (HR 1.35, P = 0.004). Any complication in the first-eye PVD (HR 3.66, P < 0.001) greatly increased risk. Age >65 years reduced complication risk (HR 0.77, P < 0.001).
Conclusions:
After first-eye PVD, second-eye PVD may occur after several years, necessitating the need for continuous follow-up especially in higher risk groups such as younger patients, patients with first-eye VH and RB, those with pseudophakia in the second eye, and those with lattice degeneration in either eye. After onset of second-eye PVD, high-risk groups such as male patients, those with lattice degeneration in either eye, or any history of complications in the first-eye PVD warrant closer and longer follow-up because of greater risk for complications after second-eye PVD.
Financial Disclosure(S):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
