Study finds, Various Complications of Acute Posterior Vitreo
A Study was conducted to evaluate the risk factors for retinal tear or detachment associated with acute, symptomatic posterior vitreous detachment (PVD) in a large comprehensive eye care setting.

8305 adult patients met the inclusion criteria. The KPNC electronic medical record was queried to capture acute, symptomatic PVD events. Each chart was reviewed to confirm diagnosis and capture specific data elements from the patient history and ophthalmic examination.

Presence of retinal tear or rhegmatogenous retinal detachment at initial presentation or within one year thereafter.

--Of 8305 patients who presented with acute PVD symptoms, 448 were diagnosed with retinal tear and 335 with rhegmatogenous retinal detachment.

--When considering variables available prior to examination, blurred vision (OR 2.7), male sex (OR 2.1), age under 60 years (OR 1.8), prior keratorefractive surgery (OR 1.6) and prior cataract surgery (OR 1.4) were associated with higher risk of retinal tear or detachment, while symptoms of flashes were mildly protective (OR 0.8).

--Examination variables associated with a high risk of retinal tear or detachment included vitreous pigment (OR 53.5), vitreous hemorrhage (OR 6.2), lattice degeneration (OR 5.0) and visual acuity worse than 20/40 (OR 3.0).

--Late retinal tears or detachments occurred in 12.4% of patients who had vitreous hemorrhage, lattice degeneration or a history of retinal tear or detachment in the fellow eye at initial presentation, but only 0.7% of patients without any of these three risk factors.

--Refractive error had an approximately linear relationship with age at presentation of PVD, with myopic patients presenting at a younger age (r = 0.4).

Finally, this study demonstrated that the rate of retinal tear and rhegmatogenous detachment associated with acute PVD was lower in a comprehensive eye care context than previously reported by retina specialized practices. Several patient characteristics highly predicted the presence of acute PVD's early and late complications.