Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development

Verena C. Mulder, Elon H.C. van Dijk, Ida A. van Meurs, Ellen C. La Heij, Jan C. van Meurs

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR. Methods: We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6 weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6 months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on. Results: Reoperation for postoperative PVR was needed in 12 (6.2%) patients; in 18 (9.2%), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2 weeks (p = 0.001) and 6 weeks (p < 0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2 weeks [odds ratio (OR) 1.027; 95% CI: 1.010-1.044] or 6 weeks (OR 1.076; 95% CI: 1.038-1.115). Conclusion: Flare values both at 2 and 6 weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.

Original languageEnglish
Pages (from-to)192-196
Number of pages5
JournalActa Ophthalmologica
Volume96
Issue number2
DOIs
Publication statusPublished - 1 Mar 2018

Cite this

Mulder, V. C., van Dijk, E. H. C., van Meurs, I. A., La Heij, E. C., & van Meurs, J. C. (2018). Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development. Acta Ophthalmologica, 96(2), 192-196. https://doi.org/10.1111/aos.13560
Mulder, Verena C. ; van Dijk, Elon H.C. ; van Meurs, Ida A. ; La Heij, Ellen C. ; van Meurs, Jan C. / Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development. In: Acta Ophthalmologica. 2018 ; Vol. 96, No. 2. pp. 192-196.
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title = "Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development",
abstract = "Purpose: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR. Methods: We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6 weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6 months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on. Results: Reoperation for postoperative PVR was needed in 12 (6.2{\%}) patients; in 18 (9.2{\%}), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2 weeks (p = 0.001) and 6 weeks (p < 0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2 weeks [odds ratio (OR) 1.027; 95{\%} CI: 1.010-1.044] or 6 weeks (OR 1.076; 95{\%} CI: 1.038-1.115). Conclusion: Flare values both at 2 and 6 weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.",
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Mulder, VC, van Dijk, EHC, van Meurs, IA, La Heij, EC & van Meurs, JC 2018, 'Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development' Acta Ophthalmologica, vol. 96, no. 2, pp. 192-196. https://doi.org/10.1111/aos.13560

Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development. / Mulder, Verena C.; van Dijk, Elon H.C.; van Meurs, Ida A.; La Heij, Ellen C.; van Meurs, Jan C.

In: Acta Ophthalmologica, Vol. 96, No. 2, 01.03.2018, p. 192-196.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development

AU - Mulder, Verena C.

AU - van Dijk, Elon H.C.

AU - van Meurs, Ida A.

AU - La Heij, Ellen C.

AU - van Meurs, Jan C.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Purpose: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR. Methods: We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6 weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6 months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on. Results: Reoperation for postoperative PVR was needed in 12 (6.2%) patients; in 18 (9.2%), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2 weeks (p = 0.001) and 6 weeks (p < 0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2 weeks [odds ratio (OR) 1.027; 95% CI: 1.010-1.044] or 6 weeks (OR 1.076; 95% CI: 1.038-1.115). Conclusion: Flare values both at 2 and 6 weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.

AB - Purpose: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR. Methods: We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6 weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6 months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on. Results: Reoperation for postoperative PVR was needed in 12 (6.2%) patients; in 18 (9.2%), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2 weeks (p = 0.001) and 6 weeks (p < 0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2 weeks [odds ratio (OR) 1.027; 95% CI: 1.010-1.044] or 6 weeks (OR 1.076; 95% CI: 1.038-1.115). Conclusion: Flare values both at 2 and 6 weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.

KW - Laser flare

KW - Proliferative vitreoretinopathy

KW - Retinal detachment

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U2 - 10.1111/aos.13560

DO - 10.1111/aos.13560

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VL - 96

SP - 192

EP - 196

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

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