McCullagh et al reported the Belfast Retinal Tear and Detachment (BERT) Score for evaluating a patient presenting with flashes and floaters. This can help to distinguish between retinal tears/detachments from uncomplicated posterior vitreous detachments (PVD). The authors are from Royal Victoria Hospital Belfast and Oxford University Hospitals.
Patient selection: flashes and floaters
Parameters:
(1) sex of the patient
(2) myope (nearsighted)
(3) blurred vision
(4) shadow
(5) vitreous hemorrhage
(6) tobacco dust (Shafer's sign; the presence of a collection of brown pigmented cells in the anterior vitreous following posterior retinal detachment)
Parameter
Finding
Points
sex of the patient
female
0
male
1
myope
no
0
yes
1
blurred vision
no
0
yes
2
shadow
no
0
yes
2
vitreous hemorrhage
no
0
yes
3
tobacco dust
no
0
yes
4
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• A score >=4 is associated with a greater risk for retinal tear/detachment.
• A score <= 3 is primarily seen with an uncomplicated vitreous detachment.
According to Figure 1, retinal tear/detachment represented < 2% of patients with a score <= 3 and 40% of patients with a score >= 4.
Performance:
• The sensitivity was 90% and specificity 80%.
• The negative predictive value was 98%.
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