Risk factors affecting visual outcomes following vitrectomy for retinal detachment secondary to branch retinal vein...

To analyze clinical characteristics and visual outcomes of retinal detachment (RD) following branch retinal vein occlusion (BRVO) in patients undergoing vitrectomy, and to identify risk factors influencing visual prognosis.

This retrospective study included 28 consecutive eyes with RD secondary to BRVO that underwent vitrectomy between January 2013 and December 2021. Preoperative data included best-corrected visual acuity (BCVA), fibrovascular membrane (FVM) severity (non-FVM, mild FVM, severe FVM), macular status, and retinal detachment extent. All patients underwent 23-gauge pars plana vitrectomy with phacoemulsification. Visual outcomes and complications were analyzed using univariable and multivariable regression models.

Mean patient age was 59.3 ± 6.7 years with 60.7% being female. Median preoperative BCVA was counting fingers. Retinal reattachment was achieved in all 28 eyes with no recurrent RD during follow-up. Three patients (10.7%) developed postoperative macular holes (MH), with two achieving spontaneous closure. Multivariable analysis revealed that severe FVM (coefficient = 0.351, 95%CI: 0.119-0.642, P = 0.003) and macula-off status (coefficient = 0.239, 95%CI: 0.064-0.422, P = 0.010) were independent risk factors for poorer final BCVA. Preoperative BCVA did not correlate with final visual outcomes (P = 0.764).

In this small retrospective series, vitrectomy achieved a high anatomical reattachment rate for RD secondary to BRVO. Severe fibrovascular membranes and macula-off retinal detachment were identified as independent risk factors associated with poorer visual outcomes. Postoperative MH formation was observed, particularly in eyes with FVM.