Since there seem to be numerous factors influencing LFP, a comprehensive scientific analysis of possible associations is desirable. Few studies have investigated LFP in eyes with RRD [3, 4, 10,11,12], and to date no data has been published describing the potential associations between laser flare values, anatomical details, and symptom duration in RRD. We investigated these characteristics to enhance existing knowledge and as experience has shown that they are often associated with each other in everyday clinical practice in the care of patients with retinal detachment.

In the current study, we found that a longer symptom duration in eyes with primary RRD in the first week leads to an increase in laser flare values potentially because of the persisting disruption in the blood-ocular barrier [7]. This is supported by the fact that eyes with longer-lasting RRD and higher laser flare values reveal greater inflammation and infiltration by activated macrophages over time. Together with the neurosensory retina’s being separated from the retinal pigment epithelium, this is associated with changes in cytokine and chemokine levels [2, 5, 6, 13].

Furthermore, there seems to be a relationship between anatomical features in case of RRD, such as the macula attachment status and quadrant numbers affected by the RRD. We demonstrate that these characteristics are also associated (in terms of their extent) with significantly higher laser flare values. Moreover, in eyes with advanced RRD (macula off, 4 affected quadrants) we noted a significant association with aqueous flare intensity and longer symptom duration. These results confirm the analyses from previous studies and appear reasonable in the light of the previously described clinical understanding of blood-ocular barrier disruption in patients with retinal detachment.

Interestingly, pseudophakic eyes revealed higher laser flare values than phakic eyes. However, as mentioned before in phakic eyes, laser flare values were significantly higher with longer symptom duration, but not in pseudophakic eyes. A possible cause of increased readings in pseudophakia could be an increased flare due to recent cataract surgery. Unfortunately, prior surgeries are often performed outside of our clinic in an outpatient setting and complete data regarding the exact time interval between other procedures such as cataract surgery are not always available. In addition, it must be considered that in pseudophakia there might be an increased flow of protein from the vitreous cavity into the anterior chamber of the eye. In previous studies, Miyake's analyses using vitreous fluorophotometry indicated that blood-ocular barrier disruption was related to surgical method (intracapsular cataract extraction and extracapsular cataract extraction) and age. Furthermore, a longer duration of the barrier disturbance than initially suspected was observed [8, 9]. Further research and analysis on this phenomenon are already underway in a complementary study (unpublished data).

Limitations of the present study are its retrospective design. We could not report the exact duration of symptoms in hours or single days for all patients, so that a detailed association with laser flare values was not possible, and groups had to be formed based on symptom durations as recorded in the patients’ files.

Furthermore, the postsurgical course of laser flare values in association with anatomical parameters and symptom durations deserves further investigation as well. Our data do not yet allow an investigation of a possible association between preoperatively measured flare values and postoperative outcomes including visual acuity improvement and PVR development, as well as surgical success. Another limitation for the investigation of these questions is the size of the studied collective. A much larger cohort would be needed to obtain reliable results, so a multicentre, prospective, randomized study is desirable. Nevertheless, the presented analyses and new results contribute to previous knowledge and lead to a better understanding of the influencing factors of LFP and blood-ocular barrier disorder. In eyes with RRD, we report an association between laser flare values and symptom duration and the anatomical extent of disease in a large patient cohort for the first time. Therefore, LFP should be investigated in further clinical studies in conjunction with assessing the surgical and functional outcome.