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RISK FACTORS, ANATOMICAL, AND VISUAL OUTCOMES OF INJURED EYES WITH PROLIFERATIVE VITREORETINOPATHY: Eye Injury Vitrectomy Study

Feng, Kang MD*; Hu, Yuntao PhD*; Wang, Changguan PhD*; Shen, Lijun MD; Pang, Xiuqin MD; Jiang, Yanrong MD§; Nie, Hongping MD; Wang, Zhijun MD; Ma, Zhizhong MD*

Retina:
doi: 10.1097/IAE.0b013e3182852469
Original Study
Abstract

Purpose: To investigate potential risk factors for development of proliferative vitreoretinopathy (PVR) post trauma and evaluate the effect of PVR on anatomical and visual outcomes in injured eyes.

Methods: Overall, 179 eyes with PVR and 221 eyes without PVR after injury were selected from the database of the Eye Injury Vitrectomy Study, a multicenter cohort study launched in 1997. Multivariate logistic regression was used to ascertain the independent risk factors for development of PVR and to evaluate the influence of PVR on anatomical and visual outcomes.

Results: An interval of injury and vitrectomy of more than 28 days (odds ratio, 139.25; confidence interval, 50.09–387.10), severe vitreous hemorrhage (odds ratio, 2.72; confidence interval, 1.13–6.52), and total retinal detachment (odds ratio, 12.67; confidence interval, 3.96–40.52) were important independent risk factors for PVR. One hundred and fifteen eyes (52.0%) and 49 eyes (27.4%) without and with PVR, respectively, were anatomically restored with ambulant visual acuity (≥4/200). Proliferative vitreoretinopathy, poor initial visual acuity, relative afferent pupillary defect, total retinal detachment, and retinal tear or retinal defect were unfavorable prognostic indicators.

Conclusion: Proliferative vitreoretinopathy occurs frequently in injured eyes and is associated with poor outcomes. Its onset depends on interval of injury and vitrectomy, wound location, vitreous hemorrhage, and retinal detachment. Early vitrectomy (before 2 weeks) and aggressive therapy should be considered for specific high-risk cases.

In Brief

Proliferative vitreoretinopathy occurs frequently in injured eyes and is associated with poor anatomical and visual outcomes. Its onset depends on the interval of injury and vitrectomy, wound location, vitreous hemorrhage, and retinal detachment. Early vitrectomy (before 2 weeks) is recommended, and more aggressive therapy should be considered in specific high-risk cases.

Author Information

*Peking University Eye Center, Peking University Third Hospital, Ministry of Education's Key Laboratory of Vision Loss and Restoration, Beijing, People’s Republic of China;

Hospital of Optometry and Ophthalmology, Wenzhou Medical College, Zhejiang Province, People’s Republic of China;

Department of Ophthalmology, Tongren Hospital, Capital University of Medical Sciences, Beijing, People’s Republic of China;

§Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China;

Department of Ophthalmology, Peking University First Hospital, Beijing, People’s Republic of China;

Chinese PLA General Hospital, Beijing, People’s Republic of China.

Reprint requests: Zhizhong Ma, MD, Peking University Eye Center, Peking University Third Hospital, Ministry of Education’s Key Laboratory of Vision Loss and Restoration, Huayuan North Street 49, Haidian, Beijing 100191, People’s Republic of China; e-mail: puh3_yk@bjmu.edu.cn

Supported by grants from the National Basic Research Program of China (973 Program, No. 2011CB510200), and Peking University Health Science Center, 211 Evidence-Based Medicine Discipline Groups, Beijing, China (No. 03-9-02). The funding organization had no role in the design or conduct of this research.

The authors have no conflict of interest to disclose.

© 2013 by Ophthalmic Communications Society, Inc.