POST TRAUMATIC PROLIFERATIVE VITREORETINOPATHY - THE EPIDEMIOLOGIC PROFILE, ONSET, RISK-FACTORS, AND VISUAL OUTCOME

Purpose: The purpose of the study was to characterize the clinical dev elopment of proliferative vitreoretinopathy (PVR) after trauma in the human eye. Methods: A chart review was performed on the records of 156 4 patients with ocular trauma seen at a large metropolitan hospital. T he frequency, type of ocular trauma, time to onset, potential risk fac tors, and visual outcome for PVR were evaluated. Results: Proliferativ e vitreoretinopathy occurred in 71 (4%) of 1654 injured eyes. Of these 71 injured eyes, 30 (42%) resulted from rupture, 15 (21%) from penetr ation, 13 (18%) from perforation, and 7 (10%) from contusion. Six (9%) were associated with an intraocular foreign body (IOFB). The frequenc y of PVR following perforation, rupture, penetration, IOFB, and contus ion was 43%, 21%, 15%, 11%, and 1%, respectively. Overall, those eyes that developed PVR had a poorer visual outcome, with PVR being the pri mary reason for visual loss. The time from injury to onset of PVR was shortest after perforation (median, 1.3 months), followed by rupture ( 2.1 months), IOFB (3.1 months), penetration (3.2 months), and contusio n (5.7 months), Vitreous hemorrhage was the strongest independent pred ictive factor for the development of PVR. A long, posteriorly located wound and persistent intraocular inflammation were also important risk factors for PVR. Conclusions: These results suggest that PVR is a com mon complication following a variety of ocular injuries, and that it i s associated with a poor visual outcome. Its frequency, onset, and out come are strongly dependent on the nature of the trauma. Specific high -risk groups are identified as candidates for more aggressive therapy.