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Lookup NU author(s): Roxane Hillier
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© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. Purpose: To assess the incidence of persistent subfoveal fluid (PSFF) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) following rhegmatogenous retinal detachment (RRD) repair and to determine its association with functional outcomes. Methods: Posthoc analysis of the PIVOT randomised trial. Eyes with gradable en face and cross-sectional spectral-domain optical coherence tomography (SD-OCT) scans at 1-2 months postoperatively were included. Primary outcome was the proportion of patients with PSFF following PnR versus PPV at 1-2 months postoperatively. Secondary outcomes included association of PSFF with Early Treatment Diabetic Retinopathy Study (ETDRS) letter score at 3, 6 and 12 months and metamorphopsia score (MCHARTs) at 12 months. Results: Of 176 participants enrolled in PIVOT, 158 (89.8%) had gradable SD-OCT scans. Intergrader agreement was 0.870 (Cohen's kappa). The incidence of PSFF was 16% (13/81) following PnR and 10.4% (8/77) following PPV (p=0.298; OR=1.65, 95% CI 0.64 to 4.23). Median ETDRS score at 3 months postoperatively between eyes with and without PSFF was 71 (IQR=58-78) and 78 (IQR=70-84), respectively (difference=7 letters, p=0.037), with no significant difference at subsequent 6-month and 12-month visits. Median metamorphopsia scores in patients with versus without PSFF were: horizontal: 0.1 (IQR=0-0.3) vs 0 (IQR=0-0.2) (difference=0.1, p=0.228) and vertical: 0.25 (IQR=0-0.4) vs 0 (IQR=0-0.2) (difference=0.25, p=0.148), respectively. Conclusions: There was no significant difference in the incidence of PSFF in eyes undergoing PnR versus PPV for RRD. The presence of PSFF at 1-2 months postoperatively was associated with worse ETDRS letter score at 3 months, but there was no difference at 1 year. Trial registration number: NCT01639209.
Author(s): Bansal A, Lee WW, Sarraf D, Sadda SR, Berger AR, Wong DT, Kertes PJ, Kohly RP, Hillier RJ, Muni RH
Publication type: Article
Publication status: Published
Journal: British Journal of Ophthalmology
Year: 2023
Volume: 107
Issue: 11
Pages: 1693-1697
Online publication date: 11/08/2022
Acceptance date: 31/07/2022
ISSN (print): 0007-1161
ISSN (electronic): 1468-2079
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bjo-2021-320981
DOI: 10.1136/bjo-2021-320981
PubMed id: 35953261
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