Comparing Rhegmatogenous and Tractional Retinal Detachment in Regressed Retinopathy of Prematurity: An International, Multicenter Study.

PURPOSE: To investigate the clinical manifestations, surgical outcomes, and prognostic factors of late-onset retinal detachment (RD) in patients with regressed retinopathy of prematurity (ROP).

DESIGN

International, multicenter, retrospective case series.

SUBJECTS: Patients developing RD ≥2 years after resolution of acute ROP.

METHODS

Patients were categorized as rhegmatogenous RD (RRD) or tractional RD (TRD). Age and visual acuity (VA) at presentation, surgical outcomes, and postoperative VA were analyzed.

MAIN OUTCOME MEASURES: Clinical features and visual outcomes of RRD and TRD in patients with regressed ROP.

RESULTS

We enrolled 177 eyes from 156 patients, including RRD (168 eyes, 95%) and TRD (9 eyes, 5%). The average age of presentation was 17.0 ± 15.0 and 20.5 ± 15.5 in TRD and RRD, respectively (P = .66). Presenting best-corrected VA was 1.6 ± 1.2 and 1.5 ± 1.0 for RRD and TRD, respectively (P = 0.73). RRD showed a significant VA improvement postoperatively (P < 0.01). In contrast, TRD had a higher percentage of multiple surgeries (77.8%, P = 0.06) and a significantly poorer final reattachment rate (66.7%, P = 0.03). Poor anatomic outcomes in RRD were linked to break size >1.5 mm and prior acute-stage surgery for ROP.

CONCLUSIONS

Late-onset RD in patients with regressed ROP is predominantly rhegmatogenous (94.9%) and generally has favorable outcomes following surgical intervention. In contrast, TRD often occurs earlier, requires multiple surgeries, and has poorer anatomical and visual prognoses. Given the elevated risk of RD, particularly before age 30, regular ocular examinations are recommended for early detection and timely intervention.