title: Risk factors for rhegmatogenous retinal detachment in the submacular surgery trials: SST report No. 22.
abstract: OBJECTIVE
  To identify risk factors associated with the development of rhegmatogenous retinal detachment (RRD) in patients enrolled in the Submacular Surgery Trials.
  
  
  METHODS
  One thousand fifteen patients with eligible subfoveal neovascular lesions in the study eye were assigned randomly to observation or to surgery. Eyes were examined at 3 months, 6 months, 12 months, and 24 months after enrollment to assess study outcomes and adverse events, including RRDs. Adverse events also were reported at other times as clinical personnel became aware of them. Potential risk factors for the development of RRD in study eyes were evaluated using recursive partitioning and logistic regression analysis.
  
  
  RESULTS
  Among 506 eyes assigned to surgery, RRD developed in 44 (8.7%) compared with 4 (0.8%) of 509 eyes assigned to observation. Of the 44 eyes in which RRD developed, 27 had age-related macular degeneration (AMD) and large (>3.5 MPS disk areas) hemorrhagic subfoveal neovascular lesions at baseline and represented 16.1% of all eyes with such lesions assigned to surgery. Eyes with AMD and larger hemorrhagic lesions (>16 MPS disk areas) together with relatively poor visual acuity (best-corrected visual acuity < or =20/1280) had a higher risk of RRD (odds ratio = 6.2, 95% confidence interval: 2.2-16.7) compared with those with smaller lesions and better visual acuity at baseline.
  
  
  CONCLUSIONS
  Poor visual acuity and very large, predominantly hemorrhagic subfoveal neovascular AMD lesion type were the greatest risk factors for RRD after submacular surgery. Submacular surgery should be undertaken in such eyes with full awareness of the risk of RRD during subsequent follow-up.
authors.affiliation: Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. sstchairman@jhmi.edu
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Solomon
authors.forename: Li Ming
authors.initials: LM
authors.lastname: Dong
authors.forename: Julia A
authors.initials: JA
authors.lastname: Haller
authors.forename: Marta M
authors.initials: MM
authors.lastname: Gilson
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Hawkins
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
mesh_terms: D000368:Aged; D020256:Choroidal Neovascularization / Q000209:etiology / Q000601:surgery*; D015821:Eye Infections, Fungal / Q000150:complications / Q000601:surgery; D006660:Histoplasmosis / Q000150:complications / Q000601:surgery; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000601:surgery; D019370:Observation; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000209:etiology*; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology