Validity of aqueous flare measurement in predicting proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment

• Published in: Acta ophthalmologica (Oxford, England) Vol. 95; no. 4; pp. e278 - e283
• Main Authors: Conart, Jean‐Baptiste, Kurun, Soydan, Ameloot, François, Tréchot, Fanny, Leroy, Bertrand, Berrod, Jean‐Paul
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2017
• Subjects: aqueous flare; Aqueous Humor - diagnostic imaging; Female; Follow-Up Studies; Health risk assessment; Humans; Incidence; laser flare‐cell meter; Male; Middle Aged; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Predictive Value of Tests; Preoperative Period; proliferative vitreoretinopathy; Reproducibility of Results; Retina; retinal detachment; Retinal Detachment - diagnosis; Retinal Detachment - surgery; Retrospective Studies; Risk Factors; Statistical analysis; Statistics; Surgery; Vitreoretinal Surgery - adverse effects; Vitreoretinopathy, Proliferative - diagnosis; Vitreoretinopathy, Proliferative - epidemiology; Vitreoretinopathy, Proliferative - etiology; laser flare-cell meter; retinal detachment; aqueous flare; proliferative vitreoretinopathy
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.13254

Purpose To investigate aqueous flare as a preoperative predictor for later proliferative vitreoretinopathy (PVR) development in patients with rhegmatogenous retinal detachment (RD) and to determine the validity of this measurement in patients at low clinical risk for postoperative PVR. Methods This study included 100 eyes of 100 patients who underwent surgery for primary RD. Aqueous flare was determined preoperatively with a laser flare‐cell meter (Kowa FM‐500, Kowa Company Ltd, Tokyo, Japan). Patients were followed for at least 6 months postoperatively. Failures related to PVR were recorded for statistical analysis. Results Twenty eyes (20%) developed PVR postoperatively. Preoperative flare values in these eyes were significantly higher than in eyes with no redetachment (48.12 ± 61.24 versus 17.74 ± 29.63 photon counts per millisecond (pc/ms), p = 0.002). The odds ratio for PVR development with flare values >15 pc/ms was 12.3 (p < 0.0001, 95% confidence interval, 3.54–42.59). Of 54 eyes at low clinical risk for postoperative PVR, five developed PVR postoperatively. Flare values were significantly higher in these eyes (25.30 ± 7.10 pc/ms) than in eyes with no redetachment (12.44 ± 10.16 pc/ms, p = 0.008). Using logistic regression, the odds ratio of PVR redetachment risk increased by the factor 1.078 per 1 pc/ms of flare value (95% CI, 1.01–1.15). Conclusion Preoperative aqueous flare is a strong predictive factor for PVR redetachment. The laser flare‐cell meter provides a fast and safe tool to accurately identify patients at risk for postoperative PVR, especially when clinical examination did not predict this risk.