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Retinal detachment in retinitis pigmentosa
  1. Weng Onn Chan1,
  2. Nicholas Brennan2,
  3. Andrew R Webster2,
  4. Michel Michealides2,
  5. Mahiul M K Muqit2
  1. 1South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  2. 2Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Mahiul M K Muqit; mahi.muqit1{at}nhs.net

Abstract

Objective Retinitis pigmentosa-related retinal detachment (RPRD) is rare, and the full spectrum of retinal complications is not well defined. To describe the types of retinal detachment in patients with retinitis pigmentosa and the surgical outcomes of RPRD.

Methods This is a non-comparative, retrospective case series. An electronic database search was performed using Moorfields OpenEyes electronic health records. We identified 90 patients with RPRD between January 2000 and August 2017. Main outcome and measures are visual acuity (VA), surgical outcomes and classification of RPRD.

Results Of the 90 patients/detachments, 61 (67.8%) were rhegmatogenous retinal detachment (RRD), 19 (21.1%) were exudative, 3 (3.3%) were tractional retinal detachment (TRD) and 7 (7.8%) had combined. 37.5% (9/24) of patients with exudative retinal detachment were treated with either cryotherapy or laser, and one patient underwent vitrectomy for vitreous haemorrhage. 56/90 patients underwent surgical intervention. Nine patients presented late and were deemed inoperable (two exudative and seven RRD). Of the RRD patients with full operative record, the primary attachment rate was 76.2% (16/21) and final reattachment rate was 85.7% (18/21) over a mean 15.4-year follow-up period. Mean VA for RRD surgery improved from 6/190 (1.51 logMAR) to 6/120 (1.31 logMAR) (p=0.194). In the TRD group, the mean VA was 6/300 (1.66 logMAR) at baseline and improved after surgery to 6/48 (0.90 logMAR) (p=0.421).

Conclusions We demonstrated a final reattachment rate of 85.7% with a trend toward better vision following intervention for patients with RPRD. However, the final long-term vision may be poor due to the natural progression of retinitis pigmentosa-associated macular degeneration.

  • retina
  • treatment surgery
  • vitreous
  • vision
  • genetics
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors MMKM planned the study. NB and WOC collected the data. MMKM, WOC, and NB wrote the manuscript. NB submitted the article. ARW and MM provided advice on genetic data collected in the manuscript, and provided assistance with writing the paper.

  • Funding This work was supported by grants from the National Institute for Health Research Biomedical Research Centre at MEH National Health Service Foundation Trust and UCL Institute of Ophthalmology, Fight for Sight (UK), MEH Special Trustees, Moorfields Eye Charity, Retina UK and the Foundation Fighting Blindness (USA). The corresponding author had full access to all the data in this report and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the institutional review board of Moorfields Eye Hospital, London.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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