TY - JOUR
T1 - The predisposing pathology and clinical characteristics in the Scottish retinal detachment study
AU - Mitry, Danny
AU - Singh, Jaswinder
AU - Yorston, David
AU - Siddiqui, M. A.Rehman
AU - Wright, Alan
AU - Fleck, Brian W.
AU - Campbell, Harry
AU - Charteris, David G.
PY - 2011/7
Y1 - 2011/7
N2 - Purpose: To describe the predisposing pathology and clinical features of all incident cases of rhegmatogenous retinal detachment (RRD) recruited in Scotland during a 2-year period. Design: Prospective surveillance study of incident cases of RRD. Participants: All incident cases of RRD recruited as part of the Scottish Retinal Detachment Study. Methods: During a 2-year period, we coordinated a comprehensive system in which every case of primary RRD presenting to 1 of 6 vitreoretinal surgical sites in Scotland was examined and approached for study inclusion. Main Outcome Measures: Rhegmatogenous retinal detachment incidence, predisposing features, and clinical characteristics. Results: A total of 1202 cases were recruited. Detailed clinical information was available on 1130 (94%) of cases. By causative break, the proportions of RRD were horseshoe tear (HST) associated with posterior vitreous detachment (PVD) in 86.2%, giant retinal tear (GRT) and PVD in 1.3%, non-PVD round hole (RH) in 4.9%, retinal dialysis in 5.9%, and retinoschisis RRD in 1.6%. One in 10 cases reported significant ocular trauma. One in 5 cases were pseudophakic. Round hole RRD more frequently presented with multiple retinal breaks compared with HST RRD (67.8% vs. 48.7%; P = 0.003). In PVD-associated RRD, 56.1% (95% confidence interval [CI], 53.858.3) of breaks were identified in the superotemporal retina. In non-PVD RRD, 54.6% (95% CI, 47.961.1) of breaks were inferotemporal, followed by superotemporal in 34.9% (95% CI, 28.741.5). Lattice degeneration was present in 18.7% of affected eyes and more common in RH RRD (35.7%) than in HST RRD (19.3%) (P = 0.003). Seven percent reported an affected first-degree relative, and these cases were significantly more myopic than nonfamilial cases. Conclusions: More than 85% of RRD cases are associated with PVD and related tractional tears. Non-PVD RH RRD occurred in younger and more myopic individuals. The majority of cases are caused by more than 1 retinal break, and the macula is affected in more than 50% at presentation. Ocular trauma, previous cataract surgery, family history, and lattice degeneration are important predisposing features. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
AB - Purpose: To describe the predisposing pathology and clinical features of all incident cases of rhegmatogenous retinal detachment (RRD) recruited in Scotland during a 2-year period. Design: Prospective surveillance study of incident cases of RRD. Participants: All incident cases of RRD recruited as part of the Scottish Retinal Detachment Study. Methods: During a 2-year period, we coordinated a comprehensive system in which every case of primary RRD presenting to 1 of 6 vitreoretinal surgical sites in Scotland was examined and approached for study inclusion. Main Outcome Measures: Rhegmatogenous retinal detachment incidence, predisposing features, and clinical characteristics. Results: A total of 1202 cases were recruited. Detailed clinical information was available on 1130 (94%) of cases. By causative break, the proportions of RRD were horseshoe tear (HST) associated with posterior vitreous detachment (PVD) in 86.2%, giant retinal tear (GRT) and PVD in 1.3%, non-PVD round hole (RH) in 4.9%, retinal dialysis in 5.9%, and retinoschisis RRD in 1.6%. One in 10 cases reported significant ocular trauma. One in 5 cases were pseudophakic. Round hole RRD more frequently presented with multiple retinal breaks compared with HST RRD (67.8% vs. 48.7%; P = 0.003). In PVD-associated RRD, 56.1% (95% confidence interval [CI], 53.858.3) of breaks were identified in the superotemporal retina. In non-PVD RRD, 54.6% (95% CI, 47.961.1) of breaks were inferotemporal, followed by superotemporal in 34.9% (95% CI, 28.741.5). Lattice degeneration was present in 18.7% of affected eyes and more common in RH RRD (35.7%) than in HST RRD (19.3%) (P = 0.003). Seven percent reported an affected first-degree relative, and these cases were significantly more myopic than nonfamilial cases. Conclusions: More than 85% of RRD cases are associated with PVD and related tractional tears. Non-PVD RH RRD occurred in younger and more myopic individuals. The majority of cases are caused by more than 1 retinal break, and the macula is affected in more than 50% at presentation. Ocular trauma, previous cataract surgery, family history, and lattice degeneration are important predisposing features. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
UR - https://www.scopus.com/pages/publications/79959966585
U2 - 10.1016/j.ophtha.2010.11.031
DO - 10.1016/j.ophtha.2010.11.031
M3 - Article
C2 - 21561662
AN - SCOPUS:79959966585
SN - 0161-6420
VL - 118
SP - 1429
EP - 1434
JO - Ophthalmology
JF - Ophthalmology
IS - 7
ER -