Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients?
Ryan B Rush,1– 4 Sloan W Rush1,2 1Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Instituto de la Visión– Hospital La Carlota, Montemorelos, Nuevo León, México; 4Southwest Retina Specialists, Amarillo, TX, USACorrespond...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-01-01
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| Series: | Clinical Ophthalmology |
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| Online Access: | https://www.dovepress.com/long-standing-macula-involving-diabetic-tractional-retinal-detachments-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1797355331177676800 |
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| author | Rush RB Rush SW |
| author_facet | Rush RB Rush SW |
| author_sort | Rush RB |
| collection | DOAJ |
| description | Ryan B Rush,1– 4 Sloan W Rush1,2 1Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Instituto de la Visión– Hospital La Carlota, Montemorelos, Nuevo León, México; 4Southwest Retina Specialists, Amarillo, TX, USACorrespondence: Ryan B Rush, Southwest Retina Specialists, 7411 Wallace Blvd, Amarillo, TX, 79106, USA, Tel +1 806 351-1870, Email ryan.rush.md@gmail.comPurpose: We assess the merits of pars plana vitrectomy (PPV) in subjects with good visual acuity (VA) and a chronic macula-involving tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR).Methods: A retrospective review of medical records was undertaken. Subjects were divided into 1) a Study Group of subjects who underwent prompt PPV and 2) a Control Group of subjects in which PPV was deferred in favor of less invasive treatment options or observations. Both study and control subjects had a baseline Snellen VA of ≥ 20/50 and a PDR-associated macula-involving TRD of > 6 months duration with a minimum follow-up of 12-months.Results: There were 58 patients analyzed over an average follow-up period of 27.6 (± 7.1) months. The change in VA was similar in the Study Group compared to the Control Group (p=0.94) with both groups losing about three lines of VA during the study period (− 0.30 ± 0.52 logMAR). Although the rates of maintaining ≥ 20/200 Snellen VA and ≥ 20/50 Snellen VA were similar in the Study Group compared to the Control Group (p=0.55 and p=0.28, respectively), the Study Group had more subjects gaining ≥ 2 lines of VA during the study period (p=0.002).Conclusion: Patients presenting with good VA and a PDR-associated macula-involving TRD of > 6 months were more likely to gain ≥ 2 lines of VA when PPV was performed at baseline compared to PPV deferral until further deterioration occurred.Keywords: chronic tractional retinal detachment, diabetic vitrectomy, good visual acuity |
| first_indexed | 2024-03-08T14:09:35Z |
| format | Article |
| id | doaj.art-0480ced72fa7480fab298a0e4366c5d4 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-03-08T14:09:35Z |
| publishDate | 2024-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-0480ced72fa7480fab298a0e4366c5d42024-01-14T18:47:16ZengDove Medical PressClinical Ophthalmology1177-54832024-01-01Volume 1812913789678Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients?Rush RBRush SWRyan B Rush,1– 4 Sloan W Rush1,2 1Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Instituto de la Visión– Hospital La Carlota, Montemorelos, Nuevo León, México; 4Southwest Retina Specialists, Amarillo, TX, USACorrespondence: Ryan B Rush, Southwest Retina Specialists, 7411 Wallace Blvd, Amarillo, TX, 79106, USA, Tel +1 806 351-1870, Email ryan.rush.md@gmail.comPurpose: We assess the merits of pars plana vitrectomy (PPV) in subjects with good visual acuity (VA) and a chronic macula-involving tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR).Methods: A retrospective review of medical records was undertaken. Subjects were divided into 1) a Study Group of subjects who underwent prompt PPV and 2) a Control Group of subjects in which PPV was deferred in favor of less invasive treatment options or observations. Both study and control subjects had a baseline Snellen VA of ≥ 20/50 and a PDR-associated macula-involving TRD of > 6 months duration with a minimum follow-up of 12-months.Results: There were 58 patients analyzed over an average follow-up period of 27.6 (± 7.1) months. The change in VA was similar in the Study Group compared to the Control Group (p=0.94) with both groups losing about three lines of VA during the study period (− 0.30 ± 0.52 logMAR). Although the rates of maintaining ≥ 20/200 Snellen VA and ≥ 20/50 Snellen VA were similar in the Study Group compared to the Control Group (p=0.55 and p=0.28, respectively), the Study Group had more subjects gaining ≥ 2 lines of VA during the study period (p=0.002).Conclusion: Patients presenting with good VA and a PDR-associated macula-involving TRD of > 6 months were more likely to gain ≥ 2 lines of VA when PPV was performed at baseline compared to PPV deferral until further deterioration occurred.Keywords: chronic tractional retinal detachment, diabetic vitrectomy, good visual acuityhttps://www.dovepress.com/long-standing-macula-involving-diabetic-tractional-retinal-detachments-peer-reviewed-fulltext-article-OPTHchronic tractional retinal detachmentdiabetic vitrectomygood visual acuity |
| spellingShingle | Rush RB Rush SW Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? Clinical Ophthalmology chronic tractional retinal detachment diabetic vitrectomy good visual acuity |
| title | Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? |
| title_full | Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? |
| title_fullStr | Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? |
| title_full_unstemmed | Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? |
| title_short | Long-Standing Macula-Involving Diabetic Tractional Retinal Detachments with Good Visual Acuity: How Should We Manage These Patients? |
| title_sort | long standing macula involving diabetic tractional retinal detachments with good visual acuity how should we manage these patients |
| topic | chronic tractional retinal detachment diabetic vitrectomy good visual acuity |
| url | https://www.dovepress.com/long-standing-macula-involving-diabetic-tractional-retinal-detachments-peer-reviewed-fulltext-article-OPTH |
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