Clinical Features and Surgical Outcomes of Primary Rhegmatogenous Retinal Detachment according to Age

Gye Jung Kim; Min Chul Shin; Ho Sik Hwang; So Young Han; Cho Bum-Joo

doi:10.3341/jkos.2017.58.1.56

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Kim, Shin, Hwang, Han, and Bum-Joo: Clinical Features and Surgical Outcomes of Primary Rhegmatogenous Retinal Detachment according to Age

Original Article

J Korean Ophthalmol Soc 2017;58(1):56-61.

Published online: 30 August 2017

DOI: https://doi.org/10.3341/jkos.2017.58.1.56

Clinical Features and Surgical Outcomes of Primary Rhegmatogenous Retinal Detachment according to Age

Gye Jung Kim, M.D, Min Chul Shin, MD, PhD, Ho Sik Hwang, MD, PhD, So Young Han, M.D, Cho Bum-Joo, MD, PhD

Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea

Address reprint requests to Bum-Joo Cho, MD, PhD Department of Ophthalmology, Chuncheon Sacred Heart Hospital, #77 Sakju-ro, Chuncheon 24253, Korea Tel: 82-33-240-5176, Fax: 82-33-255-6244 E-mail: bjcho8@gmail.com

* This study was presented as an e-poster at the 114th Annual Meeting of the Korean Ophthalmological Society in 2015.

*This work was supported by Hallym University Research Fund (No. HURF-2015-17).

Received 30 June 201626 November 2016 Accepted 30 December 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) requiring sur-gery according to age.

Methods

Medical records of patients who underwent surgery for primary RRD between January 2008 and March 2016 were re-viewed retrospectively. Patients were classified into two groups according to age at diagnosis: the under-40 group and the over-40 group. The two groups were compared in terms of demographic features, ocular manifestation, operating methods, pri-mary anatomical success rate, and visual outcome.

Results

One hundred and forty-four eyes from 144 patients were included. Mean subject age was 48.6 ± 16.9 years old. The un-der-40 group involved 42 eyes from 42 patients, and the over-40 group included 102 eyes from 102 patients. Symptom duration was shorter in the under-40 group compared to the over-40 group (7.6 ± 10.7 days vs. 14.5 ± 24.4 days; p = 0.029). Proliferative vitreoretinopathy (PVR) occurred more frequently in the under-40 group (40.0% vs. 17.4%, p = 0.007) than in the over-40 group. The anatomical success rate of primary surgery was significantly different between the two groups; 78.6% in the under-40 group and 91.2% in the over-40 group ( p = 0.038). Preoperative PVR increased the rate of anatomical failure (40.0% vs. 6.2%, p < 0.001). The visual outcomes were not significantly different between the two groups.

Conclusions

RRD is combined with PVR more frequently in young patients than in old patients, which increases the failure rate of primary re-attachment surgery.

Keywords: Age, Proliferative vitreoretinopathy, Rhegmatogenous retinal detachment, Scleral buckling, Vitrectomy

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Table 1.

Baseline characteristics of patients with primary rhegmatogenous retinal detachment

	Under-40 group (≤40 years old)	Over-40 group (＞40 years old)	p-value
Age (year)	26.6 ± 9.4	57.7 ± 9.1	<0.001
Sex, male (%)	31 (73.8)	58 (56.9)	0.057
Laterality, Rt (%)	18 (42.9)	57 (55.9)	0.155
Pseudophakia (%)	2 (4.8)	22 (21.6)	<0.001
Refractive error (SE, D)	-2.8 ± 4.7	1.0 ± 5.4	0.006
Symptom duration (day)	7.6 ± 10.7	14.5 ± 24.4	0.029
Extent of RD (clock hour)	6.5 ± 2.5	5.7 ± 2.5	0.104
Macula off (%)	23 (60.5)	50 (53.8)	0.479
PVR (%)	14 (40.0)	16 (17.4)	0.007
Follow-up period (month)	20.7 ± 17.3	16.9 ± 16.5	0.208

Rt = right; SE = spherical equivalent; D = diopter; RD = retinal detachment; PVR = proliferative vitreoretinopathy.

Table 2.

Operation methods for patients with primary rhegmatogenous retinal detachment

	Total	Under-40 group (≤40 years old)	Over-40 group (＞40 years old)	p-value
SB	22 (15%)^*	13 (31%)	9 (9%)	0.002
PPV	121 (84%)	29 (69%)	92 (90%)
SF₆	94	20	74
C₃ F₈	21	4	17
SO	8	4	4
SB + PPV	1 (1%)	0	1 (1%)

SB = scleral buckling; PPV = pars plana vitrectomy; SF₆ = sulfur hexafluoride; C₃ F₈ = octafluoropropane; SO = silicone oil.

^* Percentage was calculated as the proportion among each patient group.

Figure 1.

Age-distribution of patients who underwent surgery for rhegmatogenous retinal detachment. The histogram shows bimodal distribution of rhegmatogenous retinal detachment by age.

Figure 2.

Survival curve for the anatomical success of retinal detachment surgery. Five-year survival rate of retinal re-at-tachment after primary surgery was lower in patients ≤40 years old and the survival curves were significantly different ( p = 0.029).

Figure 3.

Visual outcome after surgery for primary rhegma-togenous retinal detachment. The visual acuity was improved significantly in both groups, but there was no significant dif-ference in the visual outcome at 1 year after surgery between the two groups.

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