Timing of Delayed Retinal Pathology in Patients Presenting with Acute Posterior Vitreous Detachment in the IRIS® Registry (Intelligent Research in Sight).

OBJECTIVE: To determine the timing of delayed retinal pathology in eyes presenting with acute posterior vitreous detachment (PVD). DESIGN: Retrospective database study. SUBJECTS: Patients in the Intelligent Research in Sight (IRIS) registry found to have acute PVD based on the International Classification of Diseases, Ninth and Tenth Revision, codes were followed. METHODS: Patients coded to have a PVD from 2013 to 2018 along with common procedural technology coding of extended ophthalmoscopy were included. Ocular baseline characteristics included visual acuity, lens status, presence or absence of vitreous hemorrhage, myopia, lattice degeneration, and subspecialty training of the treating physician. MAIN OUTCOME MEASURES: Timing (days) to delayed retinal break or detachment RESULTS: A total of 434 046 eyes met inclusion/exclusion criteria, and 10 518 eyes (2.42%) presented with a delayed retinal break or detachment after initial PVD. The median time to retinal break and detachment after initial PVD was 42 (range, 1-365) days and 51 (range, 1-365) days, respectively. Eyes with vitreous hemorrhage (hazard ratio [HR], 9.30; 95% confidence interval [CI], 8.50-10.2), history of retinal break/retinal detachment in the fellow eye (HR, 3.91; 95% CI, 3.64-4.20), lattice degeneration (HR, 2.61; 95% CI, 2.35-2.90), and myopia (HR, 1.42; 95% CI, 1.33-1.53) were found to be at a higher risk of developing delayed break or detachment. CONCLUSIONS: Follow-up examination after initial PVD is necessary to diagnose delayed or missed retinal pathology. In eyes with no initial pathology, providers should consider repeat examination at least once within 6 weeks, and sooner for eyes with higher-risk features. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.