Rhegmatogenous retinal detachment: an analysis of 2315 eyes over a six-year period
Medical hypothesis, discovery & innovation in optometry,
Vol. 4 No. 4 (2023),
25 December 2023
,
Page 148-156
https://doi.org/10.51329/mehdioptometry185
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.
Keywords:
- retinal detachments
- rhegmatogenous retinal detachment
- retinal break
- retinal hole
- retinal tear
- myopias
- trauma
- macula luteas
References
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28. Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification-a review of the literature. Eye (Lond). 2020;34(4):616-631. doi: 10.1038/s41433-019-0575-z. Erratum in: Eye (Lond). 2019; pmid: 31576027
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35. Mitry D, Tuft S, McLeod D, Charteris DG. Laterality and gender imbalances in retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2011 Jul;249(7):1109-10. doi: 10.1007/s00417-010-1529-0 pmid: 20886223
36. Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol. 2010;94(6):678-84. doi: 10.1136/bjo.2009.157727 pmid: 19515646
37. Rosman M, Wong TY, Ong SG, Ang CL. Retinal detachment in Chinese, Malay and Indian residents in Singapore: a comparative study on risk factors, clinical presentation and surgical outcomes. Int Ophthalmol. 2001;24(2):101-6. doi: 10.1023/a:1016306609978 pmid: 12201344
38. Lewis H. Peripheral retinal degenerations and the risk of retinal detachment. Am J Ophthalmol. 2003;136(1):155-60. doi: 10.1016/s0002-9394(03)00144-2 pmid: 12834683
39. Yoshida I, Shiba T, Hori Y, Maeno T. Relationships between retinal break locations and the shapes of the detachments. Clin Ophthalmol. 2018;12:2213-2222. doi: 10.2147/OPTH.S177594. Erratum in: Clin Ophthalmol. 2019;13:1997. pmid: 30464382
40. Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol. 2014;157(1):9-25.e12. doi: 10.1016/j.ajo.2013.08.010 pmid: 24099276
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43. Bosch-Driessen LH, Karimi S, Stilma JS, Rothova A. Retinal detachment in ocular toxoplasmosis. Ophthalmology. 2000;107(1):36-40. doi: 10.1016/s0161-6420(99)00013-5 pmid: 10647716
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2. Mitry D, Charteris DG, Yorston D, Siddiqui MA, Campbell H, Murphy AL, et al; Scottish RD Study Group. The epidemiology and socioeconomic associations of retinal detachment in Scotland: a two-year prospective population-based study. Invest Ophthalmol Vis Sci. 2010;51(10):4963-8. doi: 10.1167/iovs.10-5400 pmid: 20554615
3. Ghazi NG, Green WR. Pathology and pathogenesis of retinal detachment. Eye (Lond). 2002;16(4):411-21. doi: 10.1038/sj.eye.6700197 pmid: 12101448
4. Zhang ZY, Sun YJ, Song JY, Fan B, Li GY. Experimental models and examination methods of retinal detachment. Brain Res Bull. 2021;169:51-62. doi: 10.1016/j.brainresbull.2021.01.004 pmid: 33434623
5. Kunikata H, Abe T, Nakazawa T. Historical, Current and Future Approaches to Surgery for Rhegmatogenous Retinal Detachment. Tohoku J Exp Med. 2019;248(3):159-168. doi: 10.1620/tjem.248.159 pmid: 31308289
6. Rasouli M, Steed SM, Tennant MT, Rudnisky CJ, Hinz BJ, Greve MD, et al. The 1-year incidence of rhegmatogenous retinal detachment post 23-gauge pars plana vitrectomy. Can J Ophthalmol. 2012;47(3):262-3. doi: 10.1016/j.jcjo.2012.03.015 pmid: 22687303
7. Gupta OP, Benson WE. The risk of fellow eyes in patients with rhegmatogenous retinal detachment. Curr Opin Ophthalmol. 2005;16(3):175-8. doi: 10.1097/01.icu.0000162377.55415.f3 pmid: 15870575
8. Johnston T, Chandra A, Hewitt AW. Current Understanding of the Genetic Architecture of Rhegmatogenous Retinal Detachment. Ophthalmic Genet. 2016;37(2):121-9. doi: 10.3109/13816810.2015.1033557 pmid: 26757352
9. Chen SN, Jiunn-Feng H, Te-Cheng Y. Pediatric rhegmatogenous retinal detachment in taiwan. Retina. 2006;26(4):410-4. doi: 10.1097/01.iae.0000238546.51756.cd pmid: 16603959
10. Li JQ, Welchowski T, Schmid M, Holz FG, Finger RP. Incidence of Rhegmatogenous Retinal Detachment in Europe - A Systematic Review and Meta-Analysis. Ophthalmologica. 2019;242(2):81-86. doi: 10.1159/000499489 pmid: 31230058
11. Yorston D, Jalali S. Retinal detachment in developing countries. Eye (Lond). 2002;16(4):353-8. doi: 10.1038/sj.eye.6700188 pmid: 12101440
12. Jamil MH, Farooq N, Khan MT, Jamil AZ. Characteristics and pattern of rhegmatogenous retinal detachment in pakistan. J Coll Physicians Surg Pak. 2012;22(8):501-4. pmid: 22868015
13. Kianersi F, Masjedi M, Moeeni HA. Retinal detachment in Isfahan Feiz hospital (an epidemiologic study). J Res Med Sci. 2009;14(4):267. pmid: 21772894
14. Rahimi M, Bagheri M, Nowroozzadeh MH. Characteristics and outcomes of pediatric retinal detachment surgery at a tertiary referral center. J Ophthalmic Vis Res. 2014;9(2):210-4. pmid: 25279123
15. DiSantostefano J. International classification of diseases 10th revision (ICD-10). The Journal for Nurse Practitioners. 2009;5(1):56-7. doi: 10.1016/j.nurpra.2008.09.020
16. Morano MJ, Khan MA, Zhang Q, Halfpenny CP, Wisner DM, Sharpe J, et al.; IRIS Registry Analytic Center Consortium. Incidence and Risk Factors for Retinal Detachment and Retinal Tear after Cataract Surgery: IRIS® Registry (Intelligent Research in Sight) Analysis. Ophthalmol Sci. 2023;3(4):100314. doi: 10.1016/j.xops.2023.100314 pmid: 37274012
17. Shahid A, Iqbal K, Iqbal SM, Ghaffar Z, Tariq M, Jehanzeb Tahir M, et al. Risk Factors Associated With Rhegmatogenous Retinal Detachment. Cureus. 2022;14(3):e23201. doi: 10.7759/cureus.23201 pmid: 35444874
18. Sung JY, Lee MW, Won YK, Lim HB, Kim JY. Clinical characteristics and prognosis of Total Rhegmatogenous retinal detachment: a matched case-control study. BMC Ophthalmol. 2020;20(1):286. doi: 10.1186/s12886-020-01560-4 pmid: 32660545
19. Shunmugam M, Shah AN, Hysi PG, Williamson TH. The pattern and distribution of retinal breaks in eyes with rhegmatogenous retinal detachment. Am J Ophthalmol. 2014;157(1):221-226.e1. doi: 10.1016/j.ajo.2013.09.011 pmid: 24200230
20. Sengillo JD, Smiddy WE, Lin B, Shoji MK, Townsend J, Yannuzzi NA, et al. Asymptomatic Rhegmatogenous Retinal Detachments: Outcomes in Patients without Initial Surgical Intervention. Ophthalmol Retina. 2023;7(3):215-220. doi: 10.1016/j.oret.2022.09.004 pmid: 36162748
21. Fivgas GD, Capone A Jr. Pediatric rhegmatogenous retinal detachment. Retina. 2001;21(2):101-6. doi: 10.1097/00006982-200104000-00001 pmid: 11321134
22. Bjerrum SS, Mikkelsen KL, La Cour M. Risk of pseudophakic retinal detachment in 202,226 patients using the fellow nonoperated eye as reference. Ophthalmology. 2013;120(12):2573-2579. doi: 10.1016/j.ophtha.2013.07.045 pmid: 24021894
23. Schwartz SG, Flynn HW. Pars plana vitrectomy for primary rhegmatogenous retinal detachment. Clin Ophthalmol. 2008;2(1):57-63. doi: 10.2147/opth.s1511 pmid: 19668388
24. Park SW, Lee JJ, Lee JE. Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives. Clin Ophthalmol. 2018;12:1605-1615. doi: 10.2147/OPTH.S153717 pmid: 30214145
25. Popovic MM, Muni RH, Nichani P, Kertes PJ. Pars plana vitrectomy, scleral buckle, and pneumatic retinopexy for the management of rhegmatogenous retinal detachment: a meta-analysis. Surv Ophthalmol. 2022;67(1):184-196. doi: 10.1016/j.survophthal.2021.05.008 pmid: 34043984
26. Fabian ID, Kinori M, Efrati M, Alhalel A, Desatnik H, Hai OV, et al. Pneumatic retinopexy for the repair of primary rhegmatogenous retinal detachment: a 10-year retrospective analysis. JAMA Ophthalmol. 2013;131(2):166-71. doi: 10.1001/2013.jamaophthalmol.361 pmid: 23411881
27. Sanjay S, Sharief S, Gopikrishna Gadde S, Poornachandra B. Paracentral acute middle maculopathy progressing to central retinal artery occlusion following corona virus disease vaccination: a multimodal imaging report. Med Hypothesis Discov Innov Optom. 2023; 4(1): 41-49. doi: 10.51329/mehdioptometry172
28. Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification-a review of the literature. Eye (Lond). 2020;34(4):616-631. doi: 10.1038/s41433-019-0575-z. Erratum in: Eye (Lond). 2019; pmid: 31576027
29. Chandra A, Banerjee P, Davis D, Charteris D. Ethnic variation in rhegmatogenous retinal detachments. Eye (Lond). 2015;29(6):803-7. doi: 10.1038/eye.2015.43 pmid: 25853394
30. Marta A, Silva N, Correia N, Pessoa B, Ferreira N, Beirão M, et al. A 15-year retrospective epidemiologic study of ocular trauma in the north of Portugal. Eur J Ophthalmol. 2021;31(3):1079-1084. doi: 10.1177/1120672120934399 pmid: 32530713
31. Van de Put MAJ, Hooymans JMM, Los LI; Dutch Rhegmatogenous Retinal Detachment Study Group. The incidence of rhegmatogenous retinal detachment in The Netherlands. Ophthalmology. 2013;120(3):616-622. doi: 10.1016/j.ophtha.2012.09.001. Erratum in: Ophthalmology. 2018;125(7):1127. pmid: 23218185
32. Govers BM, van Huet RAC, Roosing S, Keijser S, Los LI, den Hollander AI, et al. The genetics and disease mechanisms of rhegmatogenous retinal detachment. Prog Retin Eye Res. 2023:101158. doi: 10.1016/j.preteyeres.2022.101158 pmid: 36621380
33. Radeck V, Helbig H, Maerker D, Gamulescu MA, Prahs P, Barth T. Rhegmatogenous retinal detachment repair-does age, sex, and lens status make a difference? Graefes Arch Clin Exp Ophthalmol. 2022;260(10):3197-3204. doi: 10.1007/s00417-022-05674-x pmid: 35501490
34. Polkinghorne PJ, Craig JP. Northern New Zealand Rhegmatogenous Retinal Detachment Study: epidemiology and risk factors. Clin Exp Ophthalmol. 2004;32(2):159-63. doi: 10.1111/j.1442-9071.2004.00003.x pmid: 15068432
35. Mitry D, Tuft S, McLeod D, Charteris DG. Laterality and gender imbalances in retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2011 Jul;249(7):1109-10. doi: 10.1007/s00417-010-1529-0 pmid: 20886223
36. Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol. 2010;94(6):678-84. doi: 10.1136/bjo.2009.157727 pmid: 19515646
37. Rosman M, Wong TY, Ong SG, Ang CL. Retinal detachment in Chinese, Malay and Indian residents in Singapore: a comparative study on risk factors, clinical presentation and surgical outcomes. Int Ophthalmol. 2001;24(2):101-6. doi: 10.1023/a:1016306609978 pmid: 12201344
38. Lewis H. Peripheral retinal degenerations and the risk of retinal detachment. Am J Ophthalmol. 2003;136(1):155-60. doi: 10.1016/s0002-9394(03)00144-2 pmid: 12834683
39. Yoshida I, Shiba T, Hori Y, Maeno T. Relationships between retinal break locations and the shapes of the detachments. Clin Ophthalmol. 2018;12:2213-2222. doi: 10.2147/OPTH.S177594. Erratum in: Clin Ophthalmol. 2019;13:1997. pmid: 30464382
40. Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol. 2014;157(1):9-25.e12. doi: 10.1016/j.ajo.2013.08.010 pmid: 24099276
41. Li X; Beijing Rhegmatogenous Retinal Detachment Study Group. Incidence and epidemiological characteristics of rhegmatogenous retinal detachment in Beijing, China. Ophthalmology. 2003;110(12):2413-7. doi: 10.1016/s0161-6420(03)00867-4 pmid: 14644727
42. Kianersi F, Naderi Beni A, Ghanbari H, Fazel F. Ocular toxoplasmosis and retinal detachment: five case reports. Eur Rev Med Pharmacol Sci. 2012;16 Suppl 4:84-9. pmid: 23090818
43. Bosch-Driessen LH, Karimi S, Stilma JS, Rothova A. Retinal detachment in ocular toxoplasmosis. Ophthalmology. 2000;107(1):36-40. doi: 10.1016/s0161-6420(99)00013-5 pmid: 10647716
44. Jackson TL, Donachie PH, Sallam A, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 3, retinal detachment. Ophthalmology. 2014;121(3):643-8. doi: 10.1016/j.ophtha.2013.07.015 pmid: 23978624
45. Wickham L, Ho-Yen GO, Bunce C, Wong D, Charteris DG. Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes. Br J Ophthalmol. 2011;95(9):1234-8. doi: 10.1136/bjo.2010.190306 pmid: 21156702
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