The Effect of Steroid Intervention before Vitrectomy for Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment: A Meta-Analysis and Systematic Review

Abstract

Purpose

This meta-analysis discusses the effectiveness of steroid intervention before vitrectomy in patients with rhegmatogenous retinal detachment associated with choroidal detachment.

Methods

We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for randomized controlled trials and observational studies published until August 2023. We included studies involving: patients with rhegmatogenous retinal detachment associated with choroidal detachment with proliferative vitreoretinopathy; an experimental group that was not administered steroids and a control group that was administered steroids; and assessment of visual acuity, retinal reattachment rate, and complications. The heterogeneity, publication bias, and sensitivity analysis were performed to ensure the statistical power and reliability of the analysis.

Results

Two randomized controlled trials and four case-control studies involving 490 eyes were included in the meta-analysis. There were no significant differences in the primary and final retinal reattachment rates after surgery between the steroid and non-steroid groups (primary retinal reattachment rate: odds ratio = 1.01, 95% confidence interval = 0.63–1.63, p = .41; final retinal reattachment rate: odds ratio = 0.82, 95% confidence interval = 0.43–1.59, p = .33). There was no statistically significant difference in postoperative visual acuity improvement between the two groups (odds ratio = 1.19, confidence interval = 0.63–2.25, p = .69). In addition, subgroup analyses of different types of steroids showed that systemic and local administration of steroids had similar results for retinal reattachment rate and visual acuity improvement.

Conclusion

Patients with rhegmatogenous retinal detachment associated with choroidal detachment who did not receive preoperative steroids achieved the same effect as patients with rhegmatogenous retinal detachment associated with choroidal detachment who did receive preoperative steroids in terms of retinal reattachment rate and visual acuity. It is recommended that patients with rhegmatogenous retinal detachment associated with choroidal detachment undergo surgery as promptly as possible.

Keywords:

• Steroid
• rhegmatogenous retinal detachment
• choroidal detachment
• therapy
• retina

Acknowledgements

We thank the Renmin Hospital of Wuhan University for technical assistance.

Method of literature search: PubMed, Embase, and Cochrane databases were searched using combinations of the following key terms: (choroidal detachment OR rhegmatogenous retinal detachment OR RRDCD OR RRD) AND (steroids OR glucocorticoid OR dexamethasone OR hexadecadrol OR triamcinolone acetonide OR prednisone OR dehydrocortisone). All relevant studies published on or before November 2022 were included in the initial search. Hand-search of bibliographies of relevant studies was also performed to supplement database searching. Literature without full-text available in English was excluded. References of included studies were also searched. Please see Methods for the detailed inclusion and exclusion criteria.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by The National Natural Science Foundation of China under Grant No. 81600740 for L.L. and the Independent Scientific Research of Wuhan University under Grant No. 2042019kf0071 for L.L.