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RISK FACTORS AND INDIVIDUALIZED RISK STRATIFICATION FOR SEQUENTIAL BILATERAL RHEGMATOGENOUS RETINAL DETACHMENT
Mattan Arazi1,2,3, Shira Shapira Nass2, Basel Igabriye1,4
1Goldschleger Eye Institute, Sheba Medical Center, Tel HashomerTel-Aviv UniversityTel-Aviv, Israel;
Retina (Philadelphia, Pa.)
|April 30, 2026
Summary
About 12.5% of patients with rhegmatogenous retinal detachment (RD) experience fellow-eye detachment. Risk is higher in younger, highly myopic males, emphasizing the need for risk-stratified surveillance.
Area of Science:
- Ophthalmology
- Retinal Detachment Research
- Myopia Studies
Background:
- Rhegmatogenous retinal detachment (RD) can affect one or both eyes.
- Understanding predictors of fellow-eye involvement is crucial for patient management.
- Sequential bilateral RD poses a significant risk to vision.
Purpose of the Study:
- To identify predictors of sequential bilateral rhegmatogenous retinal detachment (RD).
- To quantify the patient-level risk of fellow-eye involvement after unilateral RD.
- To inform risk-stratified surveillance strategies.
Main Methods:
- Retrospective analysis of 1,480 adult patients undergoing RD repair (2010-2023).
- Comparison of demographic and clinical characteristics between unilateral and bilateral RD cases.
- Multivariable logistic regression to identify predictors; probability generation based on axial length, age, and sex.
Main Results:
- 12.5% of patients developed sequential bilateral RD.
- Younger age, male sex, and longer axial length were significant predictors.
- Axial length was the strongest predictor (OR 1.17 per mm increase); risk concentrated in younger, highly myopic individuals.
- Over one-third of fellow-eye detachments were macula-off at presentation.
Conclusions:
- Approximately 1 in 8 patients with unilateral RD develop fellow-eye detachment.
- Risk is strongly associated with axial length, particularly in younger, myopic patients.
- Findings support risk-stratified surveillance using readily available clinical measurements.
