After evaluating the risk for exudative retinal detachment (ERD) in ocular inflammatory diseases, researchers have validated clinical impressions by determining that ERD is associated with active inflammation, suggesting that controlling inflammation will likely improve the condition. While ERD is most strongly associated with Vogt-Koyanagi-Harada syndrome (VKH) and posterior scleritis, as expected, several other forms of uveitis and scleritis also were associated with ERD to a lesser degree.
In the study, 176 of 14,612 eyes with ocular inflammation presented with ERD. Among the ocular inflammatory diagnoses, only VKH syndrome, sympathetic ophthalmia, undifferentiated choroiditis and primary or secondary panuveitis were significantly associated with incident ERD. Among the 9,209 uveitic or scleritic eyes initially free of ERD, the incidence rate of ERD was 0.47% at follow-up.
The researchers observed a significant dose-response relationship with ERD prevalence and incidence for anterior chamber cells and vitreous cell activity, as well as a higher risk of presentation with ERD in association with band keratopathy, confirming the strong relationship of ERD with inflammation severity. The study also associated African American and Hispanic race with a higher risk of ERD after adjusting for other variables.
Shah DN, Al-Moujahed A, Newcomb CW, et al. Exudative retinal detachment in ocular inflammatory diseases: risk and predictive factors. Am J Opthalmol. July 2, 2020. [Epub ahead of print].