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Koen A. van Overdam, MD; Marijke Wefers Bettink-Remeijer, MD; Caroline C. Klaver, MD; Paul G. Mulder, PhD; Annette C. Moll, MD; Jan C. van Meurs, MD

Arch Ophthalmol. 2005;123:479-484.

Objective  To validate the conclusion of our previous prospective study of 250 patients with isolated posterior vitreous detachment: follow-up visits are only necessary if patients mention symptoms of flashes in combination with multiple floaters or a curtain or cloud at the initial examination, or an increase in number of floaters after the initial examination.

Methods  Prospective study of 270 consecutive patients with symptomatic isolated posterior vitreous detachment. All patients completed a questionnaire detailing their symptoms and had a full eye examination at the initial examination and at follow-up visits. Logistic regression with backward elimination was used for statistical analysis. We also performed pooled analysis of our previous and present study data.

Results  New retinal breaks developed in 10 patients (3.7%). Multiple floaters, a curtain or cloud, hemorrhages (retinal or vitreous) at the initial examination, and an increase in the number of floaters after the initial examination were found to be predictive factors for the development of new retinal breaks. These factors were also the only significant predictors after pooled analysis of both studies (520 patients, 23 breaks).

Conclusions  We assume we can formulate a safe policy for scheduling patients with isolated posterior vitreous detachment: only patients with multiple floaters, a curtain or cloud, or hemorrhages (retinal or vitreous) at the initial examination should be scheduled for reexamination. All other patients should return only if the number of floaters increases.

Author Affiliations: Vitreoretinal Department, The Rotterdam Eye Hospital (Drs van Overdam, Bettink-Remeijer, and van Meurs), Departments of Ophthalmology (Dr Klaver) and Epidemiology and Biostatistics (Dr Mulder), Erasmus University Medical Centre, Rotterdam, the Netherlands; and the Department of Ophthalmology, VU University Medical Centre, Amsterdam, the Netherlands (Dr Moll).