Rhegmatogenous retinal detachment: an analysis of 2315 eyes over a six-year period

Abstract

Background: Rhegmatogenous retinal detachment (RRD) is a form of retinal detachment caused by passage of fluid from the vitreous cavity into the space between the neurosensory retina and the retinal pigment epithelium via a retinal break or full-thickness defect. At our tertiary referral center, we evaluated the clinical and epidemiological features of RRD, and we herein report the frequency of related risk factors. Methods: In this retrospective study, we reviewed the records of patients with a final diagnosis of RRD at an academic ophthalmological referral center in Isfahan, Iran, over a six-year period. We retrieved and reviewed data from the medical records of all eligible participants, including sex, age, laterality, lens status, macular status, type of RRD, location and number of breaks, type of surgery, rate of re-operation during the first year after initial surgery, and documented clinical risk factors for RRD. Clinical risk factors were categorized as the presence of myopic refractive error, ocular trauma, history of cataract surgery, history of other ocular surgeries, history of uveitis, or undetermined. Results: We included 2315 eyes of 2229 patients with a mean (standard deviation [SD]) age of 51.1 (16.9) years and a male-to-female ratio of 1.8:1. The most common quadrants containing retinal breaks were the superotemporal quadrant (34.1%), inferotemporal quadrant (23.4%), and superonasal quadrant (10.7%). Macula-involved RRD was seen in 90% of eyes (n=2083 eyes). The most frequently identified risk factors were cataract surgery (32.9%) and myopia (22.3%) in adults, and myopia (35.0%) and ocular trauma (27.4%) in the pediatric group. Most eyes underwent pars plana vitrectomy (51.3%), whereas pneumatic retinopexy (0.7%) was the least commonly selected. Conclusions: Our results indicate that cataract surgery and myopia are the most common risk factors for RRD in adults. Myopia and ocular trauma are the most common risk factors in pediatric patients. As observed in many studies, the characteristics of the study population, including middle age, male sex, myopia, and ocular trauma, may be associated with RRD at different rates. Further population-based longitudinal studies with larger sample sizes are required to verify these preliminary observations.