Abstract
Purpose :
Retinal detachment is a sight-threatening problem. There is a lack of data on retinal detachment outcomes in incarcerated patients, a vulnerable and understudied population. The purpose of this study is to investigate pre-operative factors and outcomes of retinal detachment repair in incarcerated patients.
Methods :
We conducted a retrospective observational study of incarcerated patients who underwent rhegmatogenous retinal detachment repair at University of California, Davis Health, the referral center for incarcerated patients in the Northern California Central Valley region. Incarcerated patients were identified by insurance status (California Department of Corrections and Rehabilitation) in the electronic medical record (EMR), and International Classification of Disease (ICD) codes were used to identify incarcerated patients who underwent retinal detachment repair by pars plana vitrectomy (PPV), scleral buckling (SB), PPV and SB, and/or pneumatic retinopexy. Demographic information, pre-operative, intraoperative, and post-operative variables were collected. These included age at presentation, sex, duration of symptom onset prior to presentation, presence or absence of trauma, status of the macula at time of presentation, surgical procedure, achievement of retinal reattachment, and post-operative visual acuity.
Results :
27 patients were included, all of whom (100%) were male. Mean age at presentation was 52 years (range: 22 – 77). The median pre-operative visual acuity was count fingers (CF) (range: 20/20 – light perception) and mean duration of symptoms prior to presentation was 37.2 days (range: 1 – 540). A history of trauma was reported in 13 patients (48.15%). 16 patients (59.26%) presented with a macula-off detachment. Pars plana vitrectomy (PPV) was the initial procedure for a majority of patients (14, 51.9%). 21 patients (77.8%) achieved successful retinal reattachment with one procedure. All patients achieved retinal reattachment at the final visit, with a median post-operative visual acuity of 20/400 (range: 20/30 – light perception).
Conclusions :
A substantial proportion of incarcerated patients with retinal detachment report a history of trauma. Most presentations were delayed and most patients had macula-off detachments. While anatomic success was achieved in all cases, visual acuity improvement was marginal, possibly due to delayed presentation. Prompt access to care may improve outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.