Tractional Retinal Detachment in Eyes with Vitreous Hemorrhage and Proliferative Diabetic Retinopathy and Posterior Vitreous Detachment in Fellow Eye
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Purpose: To predict the presence of tractional retinal detachment (TRD) in eyes with dense vitreous hemorrhage (VH) andproliferative diabetic retinopathy (PDR) by evaluating the status of posterior vitreous detachment (PVD) in fellow eyes usingoptical coherence tomography (OCT). Methods: A total of 44 eyes from 22 patients who underwent vitrectomy due to dense VH with PDR were enrolled. UsingOCT, the PVD status in the fellow eye was divided into two groups (incomplete and complete PVD). The incomplete PVDgroup included eyes without PVD and eyes with partial PVD. B-scan ultrasonography was performed on eyes with dense VHto evaluate the presence of TRD. Both OCT and B-scan images were reviewed by four ophthalmologists (two novices and twoexperienced), and the interobserver agreement was evaluated. Results: There was a difference in the interobserver agreement regarding the presence of TRD in eyes with dense VH evaluatedby B scan between novice and experienced ophthalmologists (novice, κ = 0.421 vs. experienced, κ = 0.814), althoughthere was no difference between novice and experienced ophthalmologists in the interobserver agreement regarding thestatus of PVD in the fellow eye evaluated by OCT (novice, κ = 1.000 vs. experienced, κ = 1.000). All observed TRD during vitrectomyoccurred in eyes with incomplete PVD in the fellow eye. Logistic regression analysis revealed a statistically significantrelation between TRD and the age of the patient (odds ratio [OR], 0.874; p = 0.047), and between TRD and incomplete PVD inthe fellow eye evaluated by OCT (OR, 13.904; p = 0.042). Conclusions: Evaluation of the PVD status in the fellow eye using OCT may be a useful predictor for detecting the presenceof TRD in eyes with dense VH and PDR.
Abstract
Purpose: To predict the presence of tractional retinal detachment (TRD) in eyes with dense vitreous hemorrhage (VH) andproliferative diabetic retinopathy (PDR) by evaluating the status of posterior vitreous detachment (PVD) in fellow eyes usingoptical coherence tomography (OCT). Methods: A total of 44 eyes from 22 patients who underwent vitrectomy due to dense VH with PDR were enrolled. UsingOCT, the PVD status in the fellow eye was divided into two groups (incomplete and complete PVD). The incomplete PVDgroup included eyes without PVD and eyes with partial PVD. B-scan ultrasonography was performed on eyes with dense VHto evaluate the presence of TRD. Both OCT and B-scan images were reviewed by four ophthalmologists (two novices and twoexperienced), and the interobserver agreement was evaluated. Results: There was a difference in the interobserver agreement regarding the presence of TRD in eyes with dense VH evaluatedby B scan between novice and experienced ophthalmologists (novice, κ = 0.421 vs. experienced, κ = 0.814), althoughthere was no difference between novice and experienced ophthalmologists in the interobserver agreement regarding thestatus of PVD in the fellow eye evaluated by OCT (novice, κ = 1.000 vs. experienced, κ = 1.000). All observed TRD during vitrectomyoccurred in eyes with incomplete PVD in the fellow eye. Logistic regression analysis revealed a statistically significantrelation between TRD and the age of the patient (odds ratio [OR], 0.874; p = 0.047), and between TRD and incomplete PVD inthe fellow eye evaluated by OCT (OR, 13.904; p = 0.042). Conclusions: Evaluation of the PVD status in the fellow eye using OCT may be a useful predictor for detecting the presenceof TRD in eyes with dense VH and PDR.
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