Prophylactic laser treatment did not lower the risk of rhegmatogenous retinal detachment (RRD) in patients with acute retinal necrosis, but prophylactic vitrectomy had better results and deserves further investigation, a study in the American Journal of Ophthalmology reports.
Researchers from The Netherlands performed a retrospective study of 59 patients (63 eyes) with acute retinal necrosis who were treated in a single tertiary referral center. The subjects were divided into three groups: no prophylaxis, prophylactic laser and prophylactic vitrectomy.
The overall incidence of RRD was 44.4%, including 13% at presentation, investigators noted.
Researchers found the risk of RRD was highest in those who had prophylactic laser treatment (33 patients, 45.5%), lower in the no prophylaxis group (15 patients, 26.7%) and lowest in those who had prophylactic vitrectomy (seven patients, 14.3%). Researchers also reported baseline best-corrected visual acuity differed between the groups, but zone and percentage of involved retina did not. Additionally, a multivariable model including prophylactic laser and acute retinal necrosis severity indicated only zone was predictive of RRD.
When correcting for severity of the disease, researchers said they did not observe a reduction in the risk of RRD by prophylactic laser in eyes with acute retinal necrosis, and, therefore, “prophylactic laser may be abandoned,” the study noted.
“The role of prophylactic vitrectomy is still unclear, but deserves further investigation,” the investigators wrote in their paper.
|Risseeuw S, de Boer JH, Ten Dam-van Loon NH, van Leeuwen R. Risk of rhegmatogenous retinal detachment in acute retinal necrosis with and without prophylactic intervention. Am J Ophthalmol. June 3, 2019. [Epub ahead of print].|