Update on the incidence of rhegmatogenous retinal detachment and pseudophakia as a risk factor for rhegmatogenous retinal detachment

Abstract

Purpose : We conducted a nationwide cohort study with the aim to follow up on the incidence of rhegmatogenous retinal detachment (RRD) in Denmark and to examine the role of phacoemulsification in the increased incidence of RRD.

Methods : Our data is based on the Danish National Patient Registries, with a follow up of 22 years (1^st of January 2000 - 31^st of December 2021). The outcome was first primary RRD in an individual above 40 years and the exposure was first phacoemulsification surgery in a person. Exclusion criteria were: prior vitreoretinal-, trauma- and tumor surgery.

Results : We identified 17,483 patients with primary RRD. The age and sex adjusted incidence rate of RRD for females were 24.8 cases/100,000 persons-years (p-y) in 2021 and for male it was 46.5 new cases/100,000 p-y. The annual rate of RRD increased for both females and males in the study period, with an growth of 0.45 ± 0.06 and 1.2 ± 0.06 cases/100,000 p-y (p< 0.001), respectively.
The prevalence of pseudophakia in Denmark, grew linear with a yearly rate of 4.835 p-y for males and 7.333 p-y for females.
We found that the absolute increase of pRRD cases /100,000 p-y standardized to age and sex, was 47.7% for females and 40.9% in males. The phakic patient had an absolute growth of cases/100,000 p-y of 52.2% for females and 59.1% of males
For females, we observed a decrease in the incidence rate of pRRD with -0.95 ±0.4 cases/100,000 p-y per year (p <0.05) with a mean of 70.1 pseudophakic RRD /100,000 (95 % CI: 64.2-76.1) p-y. The pRRD incidence rate also descreased for men with -4.21±1.8 cases/100,000 p-y per year, p < 0.01 and the mean of pRRD incidence rate was 219.0 cases/100,000 (95% CI: 199.5-238.5) p-y per year.
The incidence rate of phakic RRD grew for both females and males, 0.22 ±0.2 and 0.53 ±0.04 cases/100,000 p-y per year, respectively. The average phakic RRD incidence rate were 8.6 cases/100,000 (95 % CI: 7.8-9.3) p-y per year for females and 12.7 cases/100,000 (95% CI: 11.1-14.4) p-y per year for males.

Conclusions : We continue to see a significant increase in RRD until 2022. Because of the increased phacoemulsification surgery during the last decades, the prevalence of pseudophakica is increasing and the populations at risk of pRRD is growing. We find that almost 50% of the increase in RRD is caused my more pseudophakic females and 40% is caused by more pseudophakic males.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.