The effect of age on phenotype of primary rhegmatogenous retinal detachment

Eye (Lond). 2023 Apr;37(6):1114-1122. doi: 10.1038/s41433-022-02061-y. Epub 2022 Apr 26.

Abstract

Background: To evaluate the influence of age on the clinical characteristics of primary rhegmatogenous retinal detachments (RRD).

Methods: We conducted a retrospective review of a prospectively collected dataset. Data regarding adult patients (aged 16-100 years) who had undergone primary RRD repair, were extracted from two online databases. Baseline demographics, preoperative clinical characteristics and surgical management details were collected. Age-based groups (16-30, 30-39, 40-49, 50-59, 60-69, 70-79, ≥80) were compared using univariate analysis, with multivariate testing for interaction of age with sex, laterality and pseudophakia.

Results: In total, 8,133 eyes were analysed, of which the majority (59%) were in the 50-69 age-range peaking at 60, with a male predominance (64%). Myopia was significantly more frequent in patients aged <50 years. The presence of posterior vitreous detachment increased up to 50 years, then remained >95%. Foveal involvement, grade C proliferative vitreoretinopathy, total RD and greater RD extent were more common and progressively increased after 60 years, with worsening visual acuity. Isolated superior RRDs became more prevalent with age reaching a plateau in the age-range 50-69, before reducing again; conversely, isolated inferior RRDs were commoner in those <30, with a minimum in the 70-79 age-range. The incidence of fellow-eye RRD decreased linearly with age.

Conclusions: Age appeared a key variable in RRD phenotype influencing a wide range of RRD characteristics. The higher incidence of myopia, PVD absent and bilateral RRD in patients <40 years and the significant phenotypical differences in the under 40 and over 50 age-groups highlight that there are several discrete forms of RRD.

MeSH terms

  • Eye
  • Female
  • Humans
  • Male
  • Myopia* / surgery
  • Pseudophakia / surgery
  • Retinal Detachment* / epidemiology
  • Retinal Detachment* / etiology
  • Retinal Detachment* / surgery
  • Retrospective Studies
  • Visual Acuity
  • Vitrectomy / adverse effects