Risk Factors for Proliferative Vitreoretinopathy in a Large Clinical Database

Purpose: Proliferative vitreoretinopathy (PVR) is the leading cause of surgical failure following rhegmatogenous retinal detachment (RRD). In this study, we aimed to explore ocular and systemic risk factors for PVR due to RRD in a large patient database. Methods: Patients who have a diagnosis of RRD and PVR, and who have been seen in the last seven years prior to analysis (January 2015-February 2023) were identified in the Vestrum Health database. The variables selected for univariate and multivariate analysis in this study included age, gender, history of smoking, diabetes, hypertension, dyslipidemia, anemia, Wagner syndrome, Stickler syndrome, vitreous hemorrhage, high myopia, ocular trauma, choroidal detachment, uveitis, giant retinal tear, aphakia and endophthalmitis. Eyes with proliferative diabetic retinopathy and those that had a history of PVR before the RRD diagnosis date were excluded from the study. The incidence of PVR was determined within each subset of the patient population. Results: There were 57,264 eyes that underwent a post-operative examination within 1 month following RRD diagnosis. Systemic factors younger age, female gender, smoking history, and hypertension, and ocular factors poor baseline visual acuity, history of ocular trauma, choroidal detachment, history of uveitis, giant retinal tear, pseudophakia, aphakia, and endophthalmitis were significantly and independently associated with increased odds of PVR development. Conclusion: The findings of this study indicate that there are several systemic and ocular risk factors that increase PVR development. Ophthalmologists should keep these in mind when planning surgical and therapeutic interventions for PVR prevention and treatment in patients with RRD.