Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development

Verena C Mulder, Elon H C van Dijk, Ida A van Meurs, Ellen C La Heij, Jan C van Meurs

Research output: Contribution to journalArticleResearchpeer-review

Abstract

PURPOSE: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR.

METHODS: We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6 weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6 months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on.

RESULTS: Reoperation for postoperative PVR was needed in 12 (6.2%) patients; in 18 (9.2%), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2 weeks (p = 0.001) and 6 weeks (p < 0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2 weeks [odds ratio (OR) 1.027; 95% CI: 1.010-1.044] or 6 weeks (OR 1.076; 95% CI: 1.038-1.115).

CONCLUSION: Flare values both at 2 and 6 weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.

Original languageEnglish
Pages (from-to)192-196
Number of pages5
JournalActa Ophthalmologica
Volume96
Issue number2
DOIs
Publication statusPublished - Mar 2018

Keywords

  • Aged
  • Aqueous Humor/metabolism
  • Biomarkers/metabolism
  • Endotamponade
  • False Positive Reactions
  • Female
  • Humans
  • Inflammation/metabolism
  • Male
  • Middle Aged
  • Odds Ratio
  • Postoperative Complications
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Reoperation
  • Retinal Detachment/surgery
  • Scleral Buckling
  • Sensitivity and Specificity
  • Vitrectomy
  • Vitreoretinopathy, Proliferative/etiology

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