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Symptoms Predictive for the Later Development of Retinal Breaks
Koen A. van Overdam, MD;
Marijke Wefers Bettink-Remeijer, MD;
Paul G. Mulder, PhD;
Jan C. van Meurs, MD
Arch Ophthalmol. 2001;119:1483-1486.
Objective To identify symptoms in patients with isolated posterior vitreous detachment
predictive for the later development of retinal breaks.
Methods Two hundred eighty consecutive patients seen with symptoms of posterior
vitreous detachment were prospectively asked to complete a questionnaire detailing
their symptoms. At the time of presentation and follow-up, all patients had
a full ophthalmologic examination including slitlamp biomicroscopy with Goldmann
3-mirror contact lens after maximal pupil dilatation. Two hundred fifty patients
with an isolated posterior vitreous detachment were included and reexamined
6 weeks after the onset of symptoms. If small retinal or vitreous hemorrhages
were detected, patients were reexamined after 2 weeks.
Results In 13 patients (5.2%) a retinal break was detected at reexamination.
Logistic regression analysis with backward elimination revealed that symptoms
of flashes in combination with clouds or multiple (>10) small dots at the
time of the initial examination or an increase of floaters after the initial
examination were statistically significantly (P<.001)
related to the development of new breaks. These symptoms had a predictive
value for the presence or absence of a new retinal break of 75.0% and 99.6%,
respectively.
Conclusions Specific symptoms can identify patients at risk for the development
of new retinal breaks after an initial examination in which no abnormalities
were found and may obviate the need for follow-up appointments of patients
not at risk.
From the Vitreo-Retinal Department, Rotterdam Eye Hospital (Drs van
Overdam, Bettink-Remeijer, and van Meurs), and the Department of Epidemiology
and Biostatistics, Erasmus University Medical Centre–Rotterdam (Dr Mulder),
Rotterdam, the Netherlands.
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Arch Ophthalmol 2005;123:479-484.
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