Analysis of Fellow Eye Posterior Vitreous Detachment and Complications Using a Large Database of Retina Specialists.

PURPOSE: To identify risk factors in diagnosis of second-eye posterior vitreous detachment (PVD) after first-eye PVD and subsequent complications.

DESIGN

Multicenter, retrospective observational study.

PARTICIPANTS

22.525 patients with first-eye PVD (2015-2024) from the CorEvitas Vestrum Health Database.

METHODS

Onset of fellow eye PVD and development of fellow eye complications (vitreous hemorrhage, retinal break, and retinal detachment) were evaluated after acute unilateral PVD and throughout at 9-year study period.

MAIN OUTCOME MEASURES: Time to develop fellow eye PVD following acute unilateral PVD and risk factors associated with developing complications in fellow eye after PVD.

RESULTS

Of 22 525 patients, 38.3% were diagnosed with complications after first-eye PVD within 1 year (24.3% vitreous hemorrhage [VH], 24.1% retinal break [RB], 5.2% retinal detachment [RD]). Second-eye PVD occurred in 21.2% of the 22,525 patients. The median time to diagnosis of second-eye PVD was 37 months, with 74.5% of patients diagnosed with a second-eye PVD having it within 72 months. Increased risk of second-eye PVD was associated with first-eye VH (hazard ratio [HR] 1.08, P = 0.027), first-eye RB (HR 1.13, P < 0.001), lattice degeneration in either eye (HR 1.09, P = 0.037), and pseudophakia in the second eye (HR 1.21, P < 0.001). Age >65 years (HR 0.79, P < 0.001) and male gender (HR 0.93, P = 0.022) reduced risk. In eyes that experienced a second-eye PVD, 33.2% had associated complications, of which 21.1% were detected within 12 months. Risk factors included male gender (HR 1.46, P < 0.001), lattice degeneration in either eye (HR 1.38, P < 0.001), and first-eye VH (HR 2.09, P < 0.001), RB (HR 1.78, P < 0.001), or RD (HR 1.35, P = 0.004). Any complication in the first-eye PVD (HR 3.66, P < 0.001) greatly increased risk. Age >65 years reduced complication risk (HR 0.77, P < 0.001).

CONCLUSIONS

After first-eye PVD, second-eye PVD may occur after several years, necessitating the need for continuous follow-up especially in higher risk groups such as younger patients, patients with first-eye VH and RB, those with pseudophakia in the second eye, and those with lattice degeneration in either eye. After onset of second-eye PVD, high-risk groups such as male patients, those with lattice degeneration in either eye, or any history of complications in the first-eye PVD warrant closer and longer follow-up because of greater risk for complications after second-eye PVD.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.