Incidence and Epidemiological Characteristics of Rhegmatogenous Retinal Detachment in Scotland

Abstract

Purpose: : The incidence of primary rhegmatogenous retinal detachment (RRD) in the U.K. has not been systematically examined. Obtaining an accurate incidence and distribution estimate of RRD in the general population is a crucial first step towards understanding the healthcare burden related to this disorder. Our aim was to investigate the incidence and epidemiological characteristics of primary RRD in Scotland.

Methods: : A prospective population-based incidence study was established. Between 1st November 2007 and 31^st October 2008 all patients with primary RRD referred to one of six vitreoretinal surgery sites in Scotland were recruited. RRD was defined as a retinal elevation with a retinal break (found pre- or intra-operatively) and subretinal fluid extending two or more disc diameters from the margin of the break. Secondary RRD, recurrent RRD, subclinical or asymptomatic RRD and open globe injury RRD were excluded. Incidence rates were calculated from a detailed population model based on the 2006 National census.

Results: : A total of 608 patients were newly diagnosed in Scotland during the study period from a population of 5,117,900 yielding an annual incidence of 11.88 per 100,000 of population (95%CI= 11-12.9). The mean age at presentation was 57.43 years (SD +/- 15.54). The highest incidence was found in people aged over 60 (25.78 per 100,000). The incidences of the three subtypes of RRD were: 9.07 per 100,000 for nontraumatic phakic retinal detachment, 2.56 per 100,000 for pseudophakic retinal detachment and 0.25 per 100,000 for aphakic retinal detachment. At presentation, the macula was attached in 42% of cases. The mean spherical equivalent refractive error was -2.35 diopters (Q1=-4.5; Q3=+0.5). Bilateral RRD was present in 8.2% (simultaneous and consecutive).

Conclusions: : The incidence of RRD in Scotland is comparable to most reports from other developed countries. Based on current incidence and population structure RRD will affect at least 7,000 people in the U.K. annually. The incidence of RRD increases with age and myopia. At presentation one in five cases are pseudophakic.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • retinal detachment