A Prediction Nomogram for Recurrent Retinal Detachment

Figures & data

Table 1 Baseline Characteristics of the Investigated Patients (n = 403)

Characteristics	Category	n = 403	Percentage (%)
Sex (n, %)	Female	198	49.1
	Male	205	50.9
Age (years)	Range 13–82	–	–
	Mean 52.50, median 55.00	–	–
Diabetes (n, %)	Yes	26	6.5
	No	377	93.5
Hypertension (n, %)	Yes	100	24.8
	No	303	75.2
Laterality (n, %)	Right	208	51.6
	Left	195	48.4
History of eye trauma (n, %)	Yes	33	8.2
	No	370	91.8
Surgical history (n, %)	Myopia surgery	8	2.0
	Retinal photocoagulation	11	2.7
	Cataract surgery	28	6.9
	No	356	88.3
History of the contralateral eye (n, %)	Retinal detachment	21	5.2
	No-retinal detachment	382	94.8
Duration of central vision loss (days, n, %)	£7	139	34.5
	>7	264	65.5
Lens status (n, %)	Phakic	373	92.6
	Pseudophakic	28	6.9
	Aphakia	2	0.5
Axial length (mm, n, %)	<26.00	273	67.7
	≥26.00	130	32.3
Inferior breaks (n, %)	Yes	109	27.0
	No	294	73.0
Diameter of retinal breaks, (PD, n, %)	<3	317	78.7
	≥3	86	21.3
Macular status (n, %)	On	75	18.6
	Off	328	81.4
Surgical methods (n, %)	SB	35	8.7
	PPV+ gas	79	19.6
	PPV+ SO	222	55.1
	PPV+SO+SOR	67	16.6
Recurrent retinal detachment	Yes	34	8.4
	No	369	91.6

Note: Data are presented as the number of patients unless indicated otherwise.

Abbreviations: PPV, pars plana vitrectomy; PPV+ gas, PPV+ vitreous sterile air tamponade; PPV+ SO, PPV+ vitreous silicone oil tamponade; PPV+SO+SOR, PPV+ vitreous silicone oil tamponade + silicone oil removal; SB, scleral buckling.

Table 2 Univariate and Multivariate Logistic Regression Analysis of Clinical Candidate Predictors

Variable	Univariate OR (95% CI)	P value	Multivariate OR (95% CI)	P value
Sex (n, %, Female vs Male)	0.91 (0.45–1.85)	0.801	–	–
Age (years, Continuous)	0.99 (0.97–1.02)	0.581	–	–
Diabetes (n, %, Yes vs No)	1.46 (0.41–5.12)	0.558	–	–
Hypertension (n, %, Yes vs No)	0.63 (0.25–1.56)	0.316	–	–
Laterality (n, %, Left vs Right)	1.07 (0.53–2.16)	0.844	–	–
History of eye trauma (n, %, Yes vs No)	2.10 (0.75–5.85)	0.156	–	–
Surgical history (n, %)
Myopia surgery	1.50 (0.18–12.56)	0.71	–	–
Retinal photocoagulation	0 (0-Inf)	0.99	–	–
Cataract surgery	0.81 (0.18–3.56)	0.776	–	–
No	Ref.	–	–	–
History of the contralateral eye (n, %, RD vs No-RD)	2.76 (0.87–8.72)	0.084	–	–
Duration of central vision loss (days, n, %, >7 vs £7)	0.73 (0.36–1.50)	0.393	–	–
Lens status (n, %)
Phakic	Ref.	–	–	–
Pseudophakic	1.91 (0.62–5.86)	0.26	–	–
Aphakia	0 (0-Inf)	0.99	–	–
Axial length (mm, n, %, ≥26.00 vs <26.00)	4.43 (2.12–9.28)	<0.0001	4.25 (1.79–10.1)	0.001
Inferior breaks (n, %, Yes vs No)	3.93 (1.92–8.05)	<0.0001	7.19 (2.85–18.18)	<0.0001
Diameter of retinal breaks (PD, n, %, ≥3 vs <3)	2.51 (1.20–5.25)	0.014	3.47 (1.33–9.06)	0.011
Macular status (n, %, Off vs On)	1.79 (0.61–5.23)	0.29	–	–
Surgical methods (n, %)		P<0.0001		P<0.0001
SB	Ref.	–	Ref.	–
PPV+ gas	3.38 (0.93–12.29)	0.065	9.04 (2.02–40.43)	0.004
PPV+ SO	0.1 (0.02–0.6)	0.012	0.15 (0.02–1.04)	0.055
PPV+SO+SOR	1.87 (0.48–7.29)	0.367	2.60 (0.54–12.54)	0.233

Abbreviations: PPV, pars plana vitrectomy; PPV+ gas, PPV+ vitreous sterile air tamponade; PPV+ SO, PPV+ vitreous silicone oil tamponade; PPV+SO+SOR, PPV+ vitreous silicone oil tamponade + silicone oil removal; SB, scleral buckling.

Figure 1 Clinical nomogram predicting the re-RD probability in patients with RRD. Interpretation: The nomogram represents the regression equation visually. It develops scoring criteria based on the magnitude of the regression coefficients of all independent variables in the model. Determine the value of the variable on the corresponding axis, draw a vertical line to the total points axis to determine the points, add the points of each variable, and draw a line from the total point axis to determine the re-RD probabilities at the lower line of the nomogram.

Abbreviation: re-RD, recurrent retinal detachment.

Figure 2 Receiver operating characteristic curve.

Abbreviation: AUC, area under the receiver operating characteristic curve.

Figure 3 Internal validation of the nomogram using bootstrap sampling. The ROC curve was measured by bootstrapping for 500 repetitions, and the AUC of the bootstrap stepwise model was shown.

Abbreviations: AUC, area under the receiver operating characteristic curve; ROC, receiver operating characteristic.

Figure 4 Internal validation of the nomogram using bootstrap sampling. A calibration curve was measured by bootstrapping for 500 repetitions. The X axis is the predicted probability of the nomogram, and the Y axis is the observed probability. The red line shows the ideal calibration line, while the yellow area shows the 95% confidence interval of the prediction model.

Figure 5 Decision curve analyses depict the prediction nomogram’s clinical net benefit. The graph indicates the expected net benefit per patient relative to the nomogram prediction of re-RD. Red solid line: a prediction model. Tin slash line: Assume all patients have re-RD. Solid horizontal line: Assume no patients have re-RD.

Abbreviation: re-RD, recurrent retinal detachment.