Dealing with rhegmatogenous retinal detachment in patients under 40 years old: a tertiary center results

Int Ophthalmol. 2021 Feb;41(2):475-482. doi: 10.1007/s10792-020-01597-w. Epub 2020 Oct 22.

Abstract

Purpose: The risk of rhegmatogenous retinal detachment (RRD) increases with age, but some studies report a secondary peak in younger patients. Since visual recovery in RRD depends on surgical treatment and, considering the personal, social and economic burden of low vision in the working-age population, our purpose was to analyze the features and outcomes of RRD in young patients.

Methods: Clinical data of patients under 40 years old submitted to surgery for first time RRD, consecutively selected between 2016 and 2019, was analyzed. Patients with less than 3 months follow-up were excluded.

Results: Eighty-nine eyes from 89 patients were included. Mean age was 31.2 ± 7.8 years (minimum 10 years) and 56% were female gender. Most patients (63%) had high myopia. Pars plana vitrectomy (79%) alone, combined with scleral buckling (1%) or scleral buckling alone (20%) was performed. Primary anatomical success was 72%, and final anatomical success was 91%. Final visual acuity of 20/40 or better was achieved in 29% of cases, but 28% remained under 20/400. The presence of myopia (p = 0.022), localized RRD (p = 0.007) and attached macula at presentation (p < 0.001) was associated with a better final visual acuity.

Conclusion: Management of RRD in young patients must be thorough. In younger patients, anatomical outcomes may be worse than in older patients. Myopia may be recognized as a major risk factor for RRD in this age group, but also as a protective factor for retinal function after surgery.

Keywords: Myopia; RRD; Rhegmatogenous retinal detachment; Scleral buckling; Vitrectomy; Young patients.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Retinal Detachment* / diagnosis
  • Retinal Detachment* / epidemiology
  • Retinal Detachment* / etiology
  • Retrospective Studies
  • Scleral Buckling
  • Treatment Outcome
  • Vitrectomy
  • Young Adult