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Published on: February 12, 2018
Sociodemographic Factors Influencing Rhegmatogenous Retinal Detachment Presentation and Outcome
David Xu1, Joshua Uhr1, Samir N Patel1
1The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania.
Purpose:
The impact of sociodemographic factors on the presentation and outcomes of rhegmatogenous retinal detachment (RRD) in the United States has not been described. We analyzed the impact of these factors on the presenting fovea-on or off status of RRD, single operation anatomic success (SOAS) of repair, and postoperative visual acuity (VA).
Design:
Retrospective, single-center, cohort study.
Participants:
Participants included 4061 patients from Wills Eye Hospital/Mid Atlantic Retina from February 2015 to February 2020.
Methods:
Sociodemographic factors including age, gender, race, and regional mean household income (MHI) as determined by ZIP code were recorded. The VA at baseline and 12 months post-RRD repair was recorded. Multiple regression analysis was used to evaluate the relationship between sociodemographic factors to fovea-on or off presentation of RRD, SOAS, and 12-month VA.
Main Outcome Measures:
Foveal attachment at presentation of RRD, SOAS, and 12-month VA.
Results:
Older age (odds ratio [OR], 1.34 per decade, 95% confidence interval [CI], 1.27-1.41, P < 0.001), male gender (OR, 1.27, 95% CI, 1.11-1.45, P < 0.001), non-White race (OR, 2.41, 95% CI, 1.92-3.03, P < 0.001), and lower MHI (OR, 0.94 per $10 000, 95% CI, 0.91-0.98, P = 0.005) were independent risk factors for fovea-off presentation of RD. The need for reoperation to repair RRD within 90 days was independently associated with fovea-off presentation (OR, 1.47, 95% CI, 1.24-1.74, P < 0.001) and non-White race (OR, 1.72, 95% CI, 1.27-2.39, P < 0.001). Finally, 12-month postoperative VA was worse in patients who were fovea-off (P < 0.001), older (P = 0.041), male (P = 0.038), and non-White (P = 0.007) but was not related to MHI (P = 0.24).
Conclusions:
These findings reveal associations between the sociodemographic factors and the presentation and outcomes of RRD. Physicians should be aware that socioeconomic disparities can negatively impact the prognosis of patients with RRD. Further study confirming these findings and efforts to mitigate their effects are warranted and will be of interest to the greater ophthalmology community.
