Disease or general study area: Uncomplicated rhegmatogenous retinal detachment (RRD) and risk of proliferative vittroretinopathy (PVR)

Purpose and nature of the study:

1. Characterise the cytokine profile of vitreous fluid in uncomplicated RRD.
2. Develop a risk model to predict development of PVR after retinal detachment surgery using imaging and molecular biomarkers.
3. To develop deep learning/artificial intelligence (AI) models for PVR detection in retinal detachment.

Inclusion criteria:

50 adult ( ≥18 years) patients with uncomplicated rhegmatogenous retinal detachments without PVR.

What participating will involve:

Pre- and post-operative assessments and intervention will follow standard of care for patients with rhegmatogenous retinal detachments.

Additional intervention will include non-invasive imaging of anterior chamber flare, vitreous, wide-field retina, macula optical coherence tomography (OCT) and macula OCT-angiography (OCT-A) as well as, seeking participant's consent on collecting their vitreous fluid at time of their surgery for cytokine analysis.

This is an observational cohort study of 50 participants with uncomplicated rhegmatogenous retinal detachment. Participants will have their vitreous fluid collected at the time of surgery for cross-sectional analysis of cytokine milieu and a series of pre-operative and post-operative non-invasive imaging over 3 months. Unfortunately, 15-20% of the patients with primary retinal detachment will have recurrent retinal detachments following surgery secondary to an anomalous scarring process called proliferative vitreoretinopathy (PVR).

Therefore, aims of this study are to:

1. Characterise the cytokine profile of vitreous fluid in uncomplicated RRD.
2. Develop a risk model to predict development of PVR after retinal detachment surgery using imaging and molecular biomarkers.
3. To develop deep learning/artificial intelligence (AI) models for PVR detection in retinal detachment.

Above will guide future treatments for PVR and further identify high risk populations not just from a clinical perspective but with the utilisation of their imaging and molecular biomarkers.

Inclusion Criteria:

• Adults ≥18 years
• Uncomplicated primary rhegmatogenous retinal detachment
• PVD present
• No PVR-A/B/C
• Phakic or pseudophakic.

Exclusion Criteria:

• Patients <18 years
• Patients lacking capacity
• Previous vitrectomy
• Previous cryopexy
• Aphakia
• No fundal view
• Diabetic retinopathy of any severity
• Retinal detachment secondary to infective causes e.g. acute retinal necrosis, toxoplasmosis scars
• Retinal detachment secondary to congenital defects e.g. optic disc pit/coloboma
• Exudative retinal detachment
• Tractional retinal detachment
• Ongoing involvement in another ocular trial.

• Adults ≥18 years
• Uncomplicated primary rhegmatogenous retinal detachment
• Moorfields Eye Hospital

Cytokine profile