Abstract
AIM—To assess clinical variables and vitreous protein as risk factors for the development of postoperative proliferative vitreoretinopathy (PVR). METHODS—A prospective study was conducted on 140 patients with a rhegmatogenous retinal detachment in whom a primary vitrectomy was performed. 12 clinical variables were recorded and vitreous samples obtained for measurement of protein concentration. Univariate and multivariate logistic regression analysis was used to determine the risk factors for PVR. RESULTS—Complete data were available for 136 of 140 patients. 40 of the 136 patients (29.4%) developed postoperative PVR. Univariate regression revealed that significant (p<0.05) risk factors included aphakia, presence of preoperative PVR, size of detachment, the use of silicone oil, and high vitreous protein level. Multivariate regression analysis revealed only aphakia (odds ratio 2.72), the presence of preoperative PVR (odds ratio 3.01), and high vitreous protein concentration (odds ratio 1.11) to be significant (p<0.05) independent, predictive risk factors for the development of PVR. CONCLUSIONS—This study has shown that the significant risk factors for PVR are preoperative PVR, aphakia, and high vitreous protein levels. Two models (clinical factors only and clinical factors and vitreous protein) were constructed to predict the probability of developing postoperative PVR and may be used to identify those at risk for possible intravitreal pharmacological treatment.
Full Text
The Full Text of this article is available as a PDF (134.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blumenkranz M., Hernandez E., Ophir A., Norton E. W. 5-fluorouracil: new applications in complicated retinal detachment for an established antimetabolite. Ophthalmology. 1984 Feb;91(2):122–130. doi: 10.1016/s0161-6420(84)34318-4. [DOI] [PubMed] [Google Scholar]
- Bonnet M. Clinical factors predisposing to massive proliferative vitreoretinopathy in rhegmatogenous retinal detachment. Ophthalmologica. 1984;188(3):148–152. doi: 10.1159/000309357. [DOI] [PubMed] [Google Scholar]
- Bonnet M. Les facteurs cliniques de risque de la PVR dans le décollement rhegmatogène de la rétine. J Fr Ophtalmol. 1994;17(8-9):530–540. [PubMed] [Google Scholar]
- Bonnet M. The development of severe proliferative vitreoretinopathy after retinal detachment surgery. Grade B: a determining risk factor. Graefes Arch Clin Exp Ophthalmol. 1988;226(3):201–205. doi: 10.1007/BF02181181. [DOI] [PubMed] [Google Scholar]
- Chignell A. H., Fison L. G., Davies E. W., Hartley R. E., Gundry M. F. Failure in retinal detachment surgery. Br J Ophthalmol. 1973 Aug;57(8):525–530. doi: 10.1136/bjo.57.8.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Connor T. B., Jr, Roberts A. B., Sporn M. B., Danielpour D., Dart L. L., Michels R. G., de Bustros S., Enger C., Kato H., Lansing M. Correlation of fibrosis and transforming growth factor-beta type 2 levels in the eye. J Clin Invest. 1989 May;83(5):1661–1666. doi: 10.1172/JCI114065. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cowley M., Conway B. P., Campochiaro P. A., Kaiser D., Gaskin H. Clinical risk factors for proliferative vitreoretinopathy. Arch Ophthalmol. 1989 Aug;107(8):1147–1151. doi: 10.1001/archopht.1989.01070020213027. [DOI] [PubMed] [Google Scholar]
- Daniels S. A., Coonley K. G., Yoshizumi M. O. Taxol treatment of experimental proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol. 1990;228(6):513–516. doi: 10.1007/BF00918482. [DOI] [PubMed] [Google Scholar]
- Fekrat S., de Juan E., Jr, Campochiaro P. A. The effect of oral 13-cis-retinoic acid on retinal redetachment after surgical repair in eyes with proliferative vitreoretinopathy. Ophthalmology. 1995 Mar;102(3):412–418. doi: 10.1016/s0161-6420(95)31007-x. [DOI] [PubMed] [Google Scholar]
- Girard P., Mimoun G., Karpouzas I., Montefiore G. Clinical risk factors for proliferative vitreoretinopathy after retinal detachment surgery. Retina. 1994;14(5):417–424. doi: 10.1097/00006982-199414050-00005. [DOI] [PubMed] [Google Scholar]
- Hui Y. N., Liang H. C., Cai Y. S., Kirchhof B., Heimann K. Corticosteroids and daunomycin in the prevention of experimental proliferative vitreoretinopathy induced by macrophages. Graefes Arch Clin Exp Ophthalmol. 1993 Feb;231(2):109–114. doi: 10.1007/BF00920223. [DOI] [PubMed] [Google Scholar]
- Kauffmann D. J., van Meurs J. C., Mertens D. A., Peperkamp E., Master C., Gerritsen M. E. Cytokines in vitreous humor: interleukin-6 is elevated in proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci. 1994 Mar;35(3):900–906. [PubMed] [Google Scholar]
- Kirmani M., Santana M., Sorgente N., Wiedemann P., Ryan S. J. Antiproliferative drugs in the treatment of experimental proliferative vitreoretinopathy. Retina. 1983 Fall-Winter;3(4):269–272. doi: 10.1097/00006982-198300340-00007. [DOI] [PubMed] [Google Scholar]
- Kosnosky W., Li T. H., Pakalnis V. A., Fox A., Hunt R. C. Interleukin-1-beta changes the expression of metalloproteinases in the vitreous humor and induces membrane formation in eyes containing preexisting retinal holes. Invest Ophthalmol Vis Sci. 1994 Dec;35(13):4260–4267. [PubMed] [Google Scholar]
- Lambrou F. H., Burke J. M., Aaberg T. M. Effect of silicone oil on experimental traction retinal detachment. Arch Ophthalmol. 1987 Sep;105(9):1269–1272. doi: 10.1001/archopht.1987.01060090127042. [DOI] [PubMed] [Google Scholar]
- Lewis H., Burke J. M., Abrams G. W., Aaberg T. M. Perisilicone proliferation after vitrectomy for proliferative vitreoretinopathy. Ophthalmology. 1988 May;95(5):583–591. doi: 10.1016/s0161-6420(88)33136-2. [DOI] [PubMed] [Google Scholar]
- Limb G. A., Little B. C., Meager A., Ogilvie J. A., Wolstencroft R. A., Franks W. A., Chignell A. H., Dumonde D. C. Cytokines in proliferative vitreoretinopathy. Eye (Lond) 1991;5(Pt 6):686–693. doi: 10.1038/eye.1991.126. [DOI] [PubMed] [Google Scholar]
- Machemer R., Aaberg T. M., Freeman H. M., Irvine A. R., Lean J. S., Michels R. M. An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1991 Aug 15;112(2):159–165. doi: 10.1016/s0002-9394(14)76695-4. [DOI] [PubMed] [Google Scholar]
- Miyake K. Blood-retinal barrier in eyes with long-standing aphakia with apparently normal fundi. Arch Ophthalmol. 1982 Sep;100(9):1437–1439. doi: 10.1001/archopht.1982.01030040415007. [DOI] [PubMed] [Google Scholar]
- Miyake K., Miyake T., Miyake C., Asakura M., Maekubo K. Outward transport of fluorescein from the vitreous in aphakic eyes. Br J Ophthalmol. 1985 Jun;69(6):428–432. doi: 10.1136/bjo.69.6.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rachal W. F., Burton T. C. Changing concepts of failures after retinal detachment surgery. Arch Ophthalmol. 1979 Mar;97(3):480–483. doi: 10.1001/archopht.1979.01020010230008. [DOI] [PubMed] [Google Scholar]
- Salah-Eldin M., Peyman G. A., el-Aswad M., Bandok B., Bahgat M. M., Niesman M. R. Evaluation of toxicity and efficacy of a combination of antineoplastic agents in the prevention of PVR. Int Ophthalmol. 1994;18(2):53–60. doi: 10.1007/BF00919240. [DOI] [PubMed] [Google Scholar]
- Tolentino F. I., Schepens C. L., Freeman H. M. Massive preretinal retraction. A biomicroscopic study. Arch Ophthalmol. 1967 Jul;78(1):16–22. doi: 10.1001/archopht.1967.00980030018004. [DOI] [PubMed] [Google Scholar]
- Wiedemann P., Leinung C., Hilgers R. D., Heimann K. Daunomycin and silicone oil for the treatment of proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol. 1991;229(2):150–152. doi: 10.1007/BF00170548. [DOI] [PubMed] [Google Scholar]
- Yoshino Y., Ideta H., Nagasaki H., Uemura A. Comparative study of clinical factors predisposing patients to proliferative vitreoretinopathy. Retina. 1989;9(2):97–100. doi: 10.1097/00006982-198909020-00004. [DOI] [PubMed] [Google Scholar]