Symptomatic posterior vitreous detachment and the incidence of delayed retinal breaks: case series and meta-analysis.
OBJECTIVE
To establish the necessity for an early follow-up examination after an initial funduscopic examination with negative results for patients with acute, symptomatic posterior vitreous detachment (PVD).


METHODS
Retrospective case-control study and meta-analysis.


METHODS
Records were reviewed of patients seeking treatment over a 4.5-year period who were diagnosed with an acute, symptomatic PVD. A MEDLINE search to identify all published observational case studies reporting vitreoretinal pathologic features after acute, symptomatic PVD.


RESULTS
The incidence of retinal tears in eyes with a symptomatic PVD was 8.2%. The overall rate of retinal break in the meta-analysis portion of the study was 21.7%. In total, 1.8% of patients had retinal tears that were not seen on initial examination. Of the 29 patients with delayed-onset retinal breaks, 24 (82.8%) had at least one of the following: vitreous hemorrhage at initial examination, hemorrhage in the peripheral retina at initial examination, or new symptoms.


CONCLUSIONS
If the results of an initial examination of a patient with an acute, symptomatic PVD are negative for retinal tears, the necessity of early follow-up may be best determined by the presence of pigmented cells in the vitreous, vitreous hemorrhage, or retinal hemorrhage. Most patients with symptomatic PVD may not need an early follow-up examination.
Coffee
Robert E
RE
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030, USA.
Westfall
Andrew C
AC
Davis
Garvin H
GH
Mieler
William F
WF
Holz
Eric R
ER
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014822:Vitreous Body / Q000473:pathology; D020255:Vitreous Detachment / Q000150:complications* / Q000175:diagnosis