Men With Infectious Uveitis at Increased Rhegmatogenous Retinal Detachment Risk

Among patients with uveitis, rhegmatogenous retinal detachment was more common among men and individuals with infectious etiology according to results of a retrospective study, which were published in the British Journal of Ophthalmology.

Researchers in New Zealand sourced data from the Auckland District Health Board collected between 2008 and 2019. The team assessed the classification and activity of uveitis, rates of retinal detachments, and outcomes following surgical repair.

Among the 2447 patients with uveitis, 50.7% were men, had a median age of 44.5 (interquartile range [IQR], 32.1-60.6) years, and 53.9% were White. Uveitis was determined to be of anterior (68.4%), infectious (24.8%), panuveitis (18.1%), intermediate (11.4%), and posterior (8.2%) etiology.

A total of 56 eyes developed retinal detachment. After a uveitis diagnosis, the rate of detachment increased from 1.0% during the first year to 1.7% at 5 years. Risk for retinal detachment associated with posterior uveitis or panuveitis (hazard ratio [HR], 3.386; 95% CI, 1.859-6.165; P <.001), gender (HR, 2.045; 95% CI, 1.077-3.890; P =.029), and infectious uveitis (HR, 1.942; 95% CI, 1.018-3.704; P =.044).

There were 32 patients who underwent surgery for retinal detachment repair. All underwent vitrectomy and many received endolaser (59.4%), gas (57.6%), and cryotherapy (53.1%) during the procedure, among others. The investigators observed a primary success rate of 81.2%. Redetachment occurred in 6 eyes.

Following surgery, at 3 months logMAR was 0.60 (IQR, 0.3-2.3) and 0.3 (IQR, 0.2-1.6) at year 2. In total, 16 patients had moderate to severe visual loss. Flat retina at final was observed in 13 patients and 11 had macula off.

This study was limited by its retrospective design and by the fact that multiple surgeons with varying specialties performed the procedures.

The study shows that among patients with uveitis, men and those with posterior uveitis, panuveitis, or infectious etiology were at increased risk for rhegmatogenous retinal detachment. Following detachment repair, visual outcomes were unpredictable.

Reference

Young-Zvandasara T, Brunner D, Welch S, et al. Rhegmatogenous retinal detachment presentation and surgery in uveitic eyes. Br J Ophthalmol. Published online July 29, 2021. doi:10.1136/bjophthalmol-2021-319268