Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 29, Issue 6, Pages 819-824Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0b013e3181a0857e
Keywords
choroidal neovascularization; rhegmatogenous retinal detachment; risk of retinal detachment; submacular surgery trials
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Funding
- NEI NIH HHS [U10 EY11547, EY11557, EY11558] Funding Source: Medline
- NATIONAL EYE INSTITUTE [U10EY011557, U10EY011558, U10EY011547] Funding Source: NIH RePORTER
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Objective: To identify risk factors associated with the development of rhegmatogenous retinal detachment (RRD) in patients enrolled in the Submacular Surgery Trials. Methods: One thousand fifteen patients with eligible subfoveal neovascular lesions in the study eye were assigned randomly to observation or to surgery. Eyes were examined at 3 months, 6 months, 12 months, and 24 months after enrollment to assess study outcomes and adverse events, including RRDs. Adverse events also were reported at other times as clinical personnel became aware of them. Potential risk factors for the development of RRD in study eyes were evaluated using recursive partitioning and logistic regression analysis. Results: Among 506 eyes assigned to surgery, RRD developed in 44 (8.7%) compared with 4 (0.8%) of 509 eyes assigned to observation. Of the 44 eyes in which RRD developed, 27 had age-related macular degeneration (AMD) and large (>3.5 MPS disk areas) hemorrhagic subfoveal neovascular lesions at baseline and represented 16.1% of all eyes with such lesions assigned to surgery. Eyes with AMD and larger hemorrhagic lesions (>16 MPS disk areas) together with relatively poor visual acuity (best-corrected visual acuity <= 20/1280) had a higher risk of RRD (odds ratio = 6.2, 95% confidence interval: 2.2-16.7) compared with those with smaller lesions and better visual acuity at baseline. Conclusion: Poor visual acuity and very large, predominantly hemorrhagic subfoveal neovascular AMD lesion type were the greatest risk factors for RRD after submacular surgery. Submacular surgery should be undertaken in such eyes with full awareness of the risk of RRD during subsequent follow-up. RETINA 29:819-824, 2009
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