Analysis of Fellow Eye Posterior Vitreous Detachment and Complications Using a Large Database of Retina Specialists.

Abstract

Purpose: To identify risk factors in diagnosis of second eye PVD after first eye PVD and subsequent complications.

Methods: This multicenter, retrospective, observational study analyzed 22,525 patients with first eye PVD (2015-2024) from the CorEvitas Vestrum Health Database.

Results: Of 22,525 patients, 38.3% were diagnosed with complications after first eye PVD within one year (24.3% vitreous hemorrhage [VH], 24.1% retinal break [RB], 5.2% retinal detachment [RD]). Second eye PVD occurred in 21.2% of the 22,525 patients. The median time to diagnosis of second eye PVD was 37 months, with 74.5% of patients diagnosed with a second eye PVD having it within 72 months. Increased risk of second eye PVD was associated with first eye VH (HR 1.08, p = 0.027), first eye RB (HR 1.13, p < 0.001), lattice degeneration in either eye (HR 1.09, p = 0.037), and pseudophakia in the second eye (HR 1.21, p < 0.001). Age > 65 (HR 0.79, p < 0.001) and male gender (HR 0.93, p = 0.022) reduced risk. 33.2% of eyes that experienced a second eye PVD had associated complications, of which 21.1% were detected within 12 months. Risk factors included male gender (HR 1.46, p < 0.001), lattice degeneration in either eye (HR 1.38, p < 0.001), and first eye VH (HR 2.09, p < 0.001), RB (HR 1.78, p < 0.001), or RD (HR 1.35, p = 0.004). Any complication in the first eye PVD (HR 3.66, p < 0.001) greatly increased risk. Age > 65 reduced complication risk (HR 0.77, p < 0.001).

Conclusions: Following first eye PVD, second eye PVD may occur after several years, necessitating the need for continuous follow-up especially in higher risk groups such as younger patients, patients with first eye VH and RB, those with pseudophakia in the second eye, and those with lattice degeneration in either eye. Following onset of second eye PVD, high risk groups such as male patients, those with lattice degeneration in either eye, or any history of complications in the first eye PVD warrant closer and longer follow-up due to greater risk for complications after second eye PVD.