A patient presents with new floaters. Why?


This patient has a superotemporal retinal detachment.

In today’s journal club, we review the PIVOT Trial which compares the difference between pneumatic retinopexy and vitrectomy for the treatment of primary rhegmatogenous retinal detachment.

This was a randomized clinical trial which was powered around a 12-month visual acuity outcome. Secondary outcomes included: visual function (NEI-25 questionnaire), metamorphopsia and anatomic outcomes. ate matter are linked to thickening of the NFL and changes at the level of the photoreceptors.

The researchers noted that eyes that were treated with pneumatic retinopexy:

• Were able to see 6 more letters 12 months after treatment (p<0.05)
• Had better visual function and less metamorphopsia
• Were 4 less likely to develop a secondary cataract.

Those that were treated with vitrectomy had a 93% reattachment rate, compared to 81% of those that received retinopexy.

In this journal club's accompanying 10 min. video, we'll review:

  • The importance of randomized clinical trials
  • The difference between vitrectomy and pneumatic retinopexy
  • What the NEI-25 questionnaire is


Jin Yang, Qinqin Zhang, Elie H. Motulsky, Marie Thulliez, Yingying Shi, Cancan Lyu, Luis de Sisternes, Mary K. Durbin, William Feuer, Ruikang K. Wang, Giovanni Gregori, Philip J. Rosenfeld. Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography. Am J Ophthalmol. Author manuscript; available in PMC 2020 Dec 1.